Author(s): GOLDENSHLUGER, A., SAKRAN, N., FRIDMAN, L., DICKER, D., RAZIEL, O., KAIS, H., TURJEMAN, T., YAVETZ, R., GOITEIN, D., DUVNOV-RAZ, G., MHALER, I., YUNGSTER, Y., BEN ARI, A., KEIDAR, A., GEPNER, Y., Institution: TEL AVIV UNIVERSITY, Country: ISRAEL, Abstract-ID: 2121

INTRODUCTION:
Metabolic bariatric surgery (MBS) is the most effective treatment for morbid obesity, yet the impact of exercise training regimens on body composition and cardiometabolic changes post-MBS remains largely unexplored.
METHODS:
A six-month randomized controlled trial was conducted with participants randomly allocated to exercise training intervention groups: aerobic (n=13), strength (n=11) or combined (n=10) exercise, and a control group (n=11) receiving routine care. The supervised exercise intervention gradually increased to 3 sessions/week for six months after MBS. Pre- and post-intervention participants were assessed for changes in body composition using Dual-x-ray absorptiometry (DEXA), abdominal adipose tissue distribution by 3-Tesla magnetic resonance imaging (MRI), cardiometabolic blood markers and body function and strength through handgrip, six-minute walk test, sit to stand and one repetition maximum test (1RM).
RESULTS:
In our preliminary results among 45 participants (aged 39.2+9.4y, 75.6% females, BMI 42.3+4.2kg/m2) mean weight loss was 31.7+8.8 kg, and 67.8+16.6% of excess weight loss percentage. Fat mass decreased by -10.6+4.6% (p>0.001) and fat-free mass (FFM) by 6.2+2.8 Kg (p<0.001). Following six months of intervention, the combined and the aerobic groups achieved greater preservation of FFM compared to the control group (-4.6+1.8, -4.59+1.67 vs. -8.67+2.3kg, respectively; p<0.05). Additionally, no significant differences were observed between the combined and strength groups regarding FFM preservation. There was a trend for a higher reduction in deep subcutaneous adipose tissue (DSAT) in the aerobic group compared to the control group (relative percentage change -35.8+15.4% vs. -16.3+12.8%, p=0.061). Additionally, the aerobic group showed a higher decrease in alanine aminotransferase levels compared to the control group (-39.1 +25.6% vs. 4.7+33.6% respectively, p<0.05). The physical activity regime was independently associated with the change in blood glucose levels after controlling for FFM loss (β=0.426, p=0.046). Physical function improved across all groups with the most notable enhancement in the aerobic and combined groups.
CONCLUSION:
This study underscores the beneficial impact of exercise interventions after MBS on muscle mass preservation, adipose tissue distribution and metabolic markers, emphasizing the importance of exercise in comprehensive obesity management.