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Lehmann, S.* ; Lange, U.G.* ; Oberbach, A.* ; Retschlag, U.* ; Morgenroth, R.* ; Busse, H.* ; Prettin, C.* ; Petroff, D.* ; Seidemann, L.* ; Blüher, M. ; Dietrich, A.*

The effect of 6 months of structured strength or endurance exercise program on weight loss after gastric bypass surgery in a randomized controlled trial.

Langenbecks Arch. Surg. 410:194 (2025)

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PURPOSE: To examine the effects of differently structured exercise programs (strength training (ST) vs endurance training (ET) vs a control group (CG)) on glucose metabolism and weight loss following Roux-en-Y Gastric Bypass (RYGB). METHODS: After RYGB, patients were randomized to a standardized ST or ET program or a control group, the intervention started within 28 days. Outcomes at 6 months were glucose and lipid metabolism, anthropometrics, inflammation, and quality of life. RESULTS: 93 patients were randomized (30 in ST and 31 in ET, 32 in CG; 28% with type 2 diabetes mellitus, 8.5% insulin-dependent). Total weight was - 2.5 kg (95% CI - 4.7 to - 0.4, p = 0.023) lower in pooled intervention group (PIG) and fat mass according to bioelectrical impedance analysis was - 3.0 kg (95% CI - 5.0 to - 1.0, p = 0.0037) lower in the PIG. Fat-free mass decreased by - 4.2 kg with no difference between the groups. The primary endpoint, glucose concentration after a 2 h oral glucose tolerance test, did not differ between the PIG and the CG, - 0.29 mmol/L (95% CI - 1.22 to 0.63, p = 0.54). Similarly, we did not detect any differences in lipid metabolism, inflammation, and quality of life between the groups. CONCLUSION: In our study, we found that an additional exercise training 6 months postoperatvely- independent of the type of training- resulted in greater weight loss and loss of fat mass. However, it had no effect on glucose/lipid parameters or inflammation beyond the surgery itself.

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