A combination of aerobic exercise at fatmax and low resistance training increases fat oxidation and maintains muscle mass, in women waiting for bariatric surgery

[Purpose]: There is no consensus on the best exercise recommendation for women affected by severe obesity while they are waiting for bariatric surgery. For this reason, the effects of a combination of aerobic exercise performed at the intensity at which maximal fat oxidation is reached (Fatmax) with low-intensity resistance training were studied.[Materials and Methods]: Twenty sedentary middle-aged Caucasian women (43.2 ± 7.5 years, BMI = 46.5 ± 5.9 kg·m−2) were allocated to a control group (CG, n = 10) that followed solely the conventional preoperative care or to an experimental group (EG, n = 10) that, in addition, performed a 12-week individualized and supervised physical activity program (PAP) that combined aerobic training at Fatmax with low-intensity resistance training.[Results]: After the PAP, maximal fat oxidation during exercise increased in the EG (0.187 ± 0.068 vs 0.239 ± 0.080 g·min-1, p = 0.025, pre vs. post, respectively), but resting fat oxidation did not (0.088 ± 0.034 vs 0.092 ± 0.029 g·min-1, p = 0.685, pre vs. post, respectively). Additionally, the resting metabolic rate in the EG was also unchanged (1869 ± 406 vs. 1894 ± 336 kcal; p = 0.827, pre vs. post, respectively), probably because of the effects of resistance training on the maintenance of fat-free mass. No significant changes were observed in the CG.[Conclusion]: A PAP that combines aerobic exercise at Fatmax with low resistance training may counteract some of the deleterious side effects of the standard presurgical care of women waiting for bariatric surgery and increase maximal fat oxidation during exercise.Open Access funding provided thanks to the CRUE-CSIC agreement with Springer Nature.This work has been carried out under the agreement for scientific cooperation among the Hospital Vinalopó, the Hospital General Universitario de Elche, and the Universidad Miguel Hernández de Elche (FISABIO3.l5X), and has been funded by the following research projects: “Physical and psychological effects of an exercise program in bariatric patients”(UEM2.11X; Escuela de Estudios Universitarios Real Madrid-Universidad Europea de Madrid) and “Physiological and psychological effects of a physical activity program on bariatric patients” (Fundación MAPFRE).Peer reviewe