Effectiveness of Combined Exercise and Nutritional-Behavioral Intervention on Health Outcomes among Patients with Bariatric Surgery

Abstract

Context: Many bariatric surgery patients experience suboptimal long-term weight outcomes, including weight regain. Weight regaining threatens the benefits initially achieved from surgery, including improved health outcomes, and patients still require hard work and lifelong behavioral change to lose and maintain weight successfully.

Aim: This study aimed to evaluate the effectiveness of combined exercise and nutritional-behavioral intervention on health outcomes among patients with bariatric surgery.

Methods: A quasi-experimental (study/control group) design was utilized in the present study that was conducted at surgical departments and outpatient clinics in the Benha University Hospital, Qualubia Governorate, from January 2021 until April 2022. A convenience sample of 85 patients ended with 60 patients who completed the study (Intervention group 30 & control group 30). They were recruited according to to sample size equation based on the patient admitted to the study setting in 2020. Two tools were utilized for data collection; the patient structured interviewing questionnaire and the patient’s health outcomes questionnaires that included anthropometric measures, eating behavior and food frequency questionnaire, international physical activity questionnaire, and the Moorehead-Ardelt quality of life questionnaire.

Results: The findings revealed a mean sample age of 35.53±4.06 for the intervention group and 34.47±4.11 for the control group. The intervention and control groups revealed a highly statistically significant difference regarding all knowledge elements and the total knowledge score. Besides, a statistically significant improvement in the intervention group's knowledge throughout the study phases. A highly statistically significant difference was revealed in the percentage of weight loss (%wt L) among the intervention group throughout the following study periods (first month, six months, and one year of intervention), with statistically significant differences between the intervention and control group after one and six months, and after one year of intervention regarding their weight, % wt L, BMI, and excess BMI loss percentage. Eating habit scores revealed statistically significant differences between the intervention and control group regarding eating behaviors and food frequency at one and six months and one year of intervention. Residence (p=0.01), total patient knowledge (p=0.002), food frequency (p=0.000), and physical activity (p=0.001) level predicted weight loss in the intervention group, while age was the only predictor in the control group (p=0.02).

Conclusion: Implementing the combined exercise and nutritional-behavioral intervention post bariatric surgery significantly improved patients' health outcomes in terms of improved patient knowledge, weight loss percentage, eating habits, physical activity, and quality of life levels among the intervention group compared to the control group. There is a need to raise knowledge of bariatric surgery patients regarding the value of living a healthy lifestyle for improving surgical outcomes and maintaining weight loss.