Physical Activity & Exercise After Bariatric Surgery

This article does not intend to start the debate about exercise versus physical activity. Some people call it exercise, but here we use the terms physical activity and fitness. It is best not to stress over what we call it, and instead stress the importance of actually doing it, being successful at it and enjoying it. The goal is to be more active and increase your fitness level after bariatric surgery – even if you have never been physically active before, or have physical limitations that make certain types of activity difficult or impossible.

Physical activity

There are several benefits to being physically active and increasing your fitness level, including, but not limited to:

• Stress relief
• Better sleep
• Increased overall energy levels
• Decreased risk of chronic disease
• Better overall mood

While all of these changes are beneficial, how do you get past the feeling of not wanting to be physically active, and feel successful with your physical activity regimen?

First things first

After bariatric surgery, being physically active and increasing your fitness level is important because it assists with losing weight and maintaining that weight loss, increases your metabolism (the rate at which you burn calories) and brings some of the benefits listed above. Always check with your bariatric surgeon before starting and/or changing your workout regimen. Ensure optimal overall success by also taking the proper bariatric vitamins and minerals, staying well hydrated and following a healthy eating plan.*

Find something you enjoy

One of the most important things you can do to achieve physical activity and fitness success is to find an activity that you can physically do and that you enjoy. You may not love it at first, but you may grow to like it and eventually love it.

• Walking in a pool: some bariatric surgery patients cannot walk long distances outside or on a treadmill, but can walk in a pool. Water makes walking much more enjoyable (no sweating and less pain in your joints).
• Cycling: maybe you hate walking but loved riding your bike as a child. If so, try cycling at the gym or outside on nice days.
• Dancing: if you were a dancer when you were younger, you might enjoy a Zumba or cardio funk class.
• Friends: ask your friends what they do for activity and/or whether they would try something new with you.

The more fun you create around your physical activity regimen, the more likely you are to stick with it and end up loving it.

Make a plan

One important piece is actually planning your physical activity and fitness regimen. Some bariatric surgery patients schedule their physical activity sessions into their daily routine just as they would a doctor's appointment or work meeting. This helps to hold you accountable and meet your goals.

One common pitfall is being overzealous from the beginning. If you have never been physically active, or it has been a long time, do not start by scheduling sessions six days a week for an hour each. Start small and increase the number of sessions and overall time as you go and are physically able. Set yourself up for success from the beginning.

For example, if you have never been physically active, you may set a goal simply to sit on your exercise bike for five minutes a day. You may find you end up cycling for those five minutes and actually enjoy it. This helps build the discipline to start the habit. Our body likes habits and is exceptional at adapting to new behaviours: if you start moving, your body will become accustomed to this new movement, start to enjoy it and eventually crave it! As the five minutes become routine, consider increasing in five-minute steps as tolerated and recommended by your bariatric surgeon.

Accountability partner

For many bariatric surgery patients, an accountability partner helps to make the physical activity plan a habit. If you know you are meeting your friend, partner or bariatric surgery buddy at the park for a daily walk, you are far less likely to skip it when someone is counting on you. The same is true for your accountability partner.

Determine the barriers and pre-plan to overcome them

Everyone has heard the same excuses or barriers before – most of us have probably used them. For example:

1. There is not enough time in the day.
2. My children have too many after-school activities.
3. I cannot afford a gym membership.
4. My job is too stressful.

Ideas to overcome them:

• Combine activity with screen time: while time is limited for everyone, most people have time for social media, mobile games and television. Walk on a treadmill or cycle on an exercise bike while watching one of your favourite programmes.
• Use waiting time: go for a walk while your children are at their after-school activities.
• No gym needed: you can be physically active without a gym membership, with a very small investment. Items for your "home gym" might include good, supportive trainers, a pedometer, exercise/resistance bands and/or a skipping rope.
• Move at work: work some physical activity into your daily work routine as a break. Not only will this help your fitness, it will also help you be more productive: you may be more focused after a quick bout of movement or some stretching.
• Split it up: break your physical activity into two or three sessions throughout the day. Some people find it easier to think about being active three times a day for ten minutes than one thirty-minute session.

Make a list of your past barriers and write down a counter-plan for each. This will help you overcome them, increase your long-term success and prevent you from falling into old habits. Make physical activity a positive experience by including a friend, listening to music, taking it outdoors on nice days, or thinking of it as your alone time, which can also be very therapeutic.

Consistency is key

While both quality and quantity are important, the initial factor that will keep you going is consistency. If you do not have time for your full session, cut it short: a fifteen-minute walk (when your normal goal is thirty minutes) is better than skipping it altogether. Knowing you completed part of the session will help you feel successful and proud. There may be another day later in the week when you can do a little extra.

Thinking about your workouts on a weekly basis helps some people. If that is you, work with your bariatric surgeon to set a weekly goal for the number of minutes to be physically active. Even when a major life event or crisis happens (which it will), it is better to do the bare minimum than to skip it completely, because it is hard to get back into your regimen once you are out of the habit.

Track your success

Just as you track your weight loss through centimetres lost, the number on the scale, changes in clothing size or body composition, it is just as important to track your physical activity and fitness success!

• How you feel: before starting your plan, write down how you feel throughout the day, mentally and physically. Every one to three months, write down the changes you notice – for example less joint pain, climbing stairs more easily, walking longer distances or being able to play with your children.
• What you do: maybe on the first day you could only ride the exercise bike for five minutes at resistance level zero (higher resistance makes it harder to pedal). After one month you may be up to twenty minutes per day, three to five days per week, at resistance level five!

Writing down what you do and reviewing it periodically helps you see your success.

Loving your physical activity and fitness plan

Now that we have discussed how to make physical activity more consistent and increase your feeling of success, how do you start to like – or even love – physical activity? Developing a love for physical activity can be difficult for some people, as can maintaining the energy to keep it up consistently. These four recommendations may help you stay focused and achieve your fitness goals:

• Remind yourself of the feel-good mood after a hard physical activity session.
• Do not make yourself feel guilty for missing one session. One session does not determine your overall success or failure; it is just one session.
• Be realistic when setting your goals. Make sure they are goals you can live with and meet each week. Consider setting a range (e.g. walk twenty to forty minutes, three to five days per week), so that in busier weeks you can complete the lower end of the range and still feel successful.
• Combine activities you enjoy with physical activity. If you love golf, play without the buggy – even walking the first nine holes is better than using a buggy for all eighteen. If you love dancing, have a dance party in your living room as your cardio for the day. If you love socialising, ask friends to meet once a week for a hike and a chat rather than for brunch.

While exercise after bariatric surgery can be a hard habit to start, once you get going you will thank yourself for starting because of all the wonderful benefits of physical activity and fitness.

* Proper supplementation should be viewed as an individualised regimen based on each patient's medical history, laboratory studies and current medication use. Patients should follow the instructions of their bariatric surgery team, follow up at the recommended intervals and stay up to date with requested lab work. Speak to your bariatric surgery team about your individual hydration plan and healthy eating plan.

This article is for general information only and does not replace personal medical advice. Always discuss your situation, blood test results and supplementation with your bariatric team or healthcare provider.