Bariatric surgery reduces aerobic exercise capacity

Let’s begin with one story. I had a patient whose BMI was 38, with hypertension and diabetes. She had tried to lose weight several times by dieting and exercise, but she was having trouble maintaining her weight loss. When she stopped the program, her weight fluctuated up and down like a Yo-Yo. She did not feel well and become very quickly breathless during exercise. Why? Because she had more subcutaneous and abdominal fat which led to difficulties breathing. Her heart carried that fat mass like a burden, so she was quickly tired. Last year, her doctor suggested an operation to reduce the size of her stomach. The goal was to lose weight. Three months later, she enthusiastically told me: "I have already lost 20 kg and now I can walk further without breathlessness". Had her physical condition already improved? Yes? No? Does weight loss after surgery equal improved physical condition? In the future, will she still improve? Introduction:Bariatric surgery has become an important treatment option in severe obesity.However, previous studies of aerobic exercise capacity after bariatric surgery weight loss showed contradicting results with either an increased, unchanged or reduced exercise capacity depending on the different protocol.The impact of weight loss after this surgery on exercise capacity remains unclear and lack of long-term outcomes makes guidelines difficult.Aim of the study:The purpose of this study was to determine how much aerobic exercise capacity during cardio-pulmonary exercise test was affected by weight loss in healthy obese women 1 year after bariatric surgery.Methods:We included healthy obese women who underwent body weight measurement, blood sampling and CPET, before and 1 year after bariatric surgery. Patients were tested on a cyclo-ergometer with an incremental increase in the workload until exhaustion. Oxygen uptake (VO2), VCO2 and ventilation were measured continuously via a facial mask.Results-01:Total 40 obese women included, with a mean age of 42 years old and a mean body mass index >40 kg/m2. One year after surgery, the weight loss was around 36 kg and the patients’ dyslipidemia, fasting blood sugar and inflammation factors were markedly reduced (p<0.01). Comparing the CPET’s before and after surgery, we found that the peak VO2 and VO2 at first ventilator threshold (VT1) were reduced after surgery when the VO2 was expressed in absolute value (p