Given that bariatric surgery is the most aggressive approach for treating severe obesity, there is interest in whether individuals who seek bariatric surgery engage in less favorable weight-control behaviors than those who opt for a less aggressive lifestyle intervention approach. However, previous research in this area has been limited to eating behaviors [3
The current study compared daily time spent in physical activity and sedentary behaviors among individuals seeking bariatric surgery versus lifestyle intervention. We found that these groups exhibited a remarkably similar profile characterized by high levels of sedentary behavior and infrequent engagement in structured or bout-related moderate-to-vigorous physical activity. Overall, bariatric surgery- and lifestyle intervention-seekers engaged in similar low levels of bout-related moderate-to-vigorous physical activity; however, a greater proportion of lifestyle intervention-seekers actually performed this type of activity. Future studies are needed to investigate possible barriers to bout-related moderate-to-vigorous physical activity in bariatric surgery-seekers (e.g., low motivation, confidence, fear of injury, etc.) that may account for this difference [14
We also compared bariatric surgery- and lifestyle intervention-seekers on HRQoL. Similar to previous studies [4
], bariatric surgery-seekers reported lower physical HRQoL than lifestyle intervention-seekers. Interestingly, however, this difference occurred despite the groups having similar body weight and physical activity levels. While reasons for this difference are not entirely clear, one possibility may be that lower perceived physical functioning is a primary reason why severely obese individuals opt for bariatric surgery, a more aggressive treatment modality, over lifestyle intervention, a more conservative treatment modality. It is also possible that this finding is due in part to differences between the groups on actual or perceived health indicators (e.g., duration of severe obesity, severity of weight-related comorbidities) that were not directly measured.
Importantly, the above finding also suggests that lower subjective physical functioning in bariatric surgery-seekers is not a barrier to PA. This discordance between subjective and objective physical functioning in bariatric surgery-seekers was also shown in another recent study, where 41
% of bariatric surgery-seekers reported having walking limitations yet did not demonstrate limitations during an objective walking test [9
Study strengths include use of an objective physical activity measure and matching of lifestyle intervention and bariatric surgery participants on potential confounding variables. This study also has certain limitations including relatively small sample size, non-random assignment of participants, and exclusion of participants with medical contraindications for physical activity, that may limit generalizability to all severely obese individuals.
In summary, to our knowledge, this is the first study to compare severely obese individuals seeking bariatric surgery or lifestyle intervention on patterns of physical activity and sedentary behaviors. We found that these groups engaged in similar levels of physical activity and sedentary behaviors, and that lower subjective physical functioning among bariatric surgery-seekers was not associated with lower overall physical activity levels. The results suggest that similar prescriptions can be used to increase physical activity and decrease sedentary behavior in severely obese individuals seeking bariatric surgery or lifestyle intervention. Further research is needed to determine whether interventions can produce similar physical activity and sedentary behavior changes in these groups.