Obesity, as one of the biggest health problems of our age, both reduces the quality of life of individuals and increases the risk of chronic diseases. According to the World Health Organisation, worldwide obesity rates have tripled in the last 50 years. This alarming situation is directly related to lifestyle changes such as unhealthy eating habits, physical inactivity and rapid urbanisation. However, research suggests that physical activity (PA) has a strong protective and curative effect against this pandemic.
Effects of Exercise on Obesity
Exercise is an essential tool in achieving energy balance and reducing metabolic risk factors associated with obesity. Physical activity forms a variable component of total energy expenditure and can be increased through both regular exercise and daily activities. Research shows that aerobic exercise (AE), resistance training (RT) and the combination of the two (AE + RT) improve weight loss, body fat percentage and metabolic health in obese individuals. In particular, the combined application of AE and RT increases fat loss by preserving muscle mass. High-intensity interval training (HIIT) has the potential to provide more fat loss in a shorter time compared to traditional exercise protocols. Studies have shown that HIIT reduces total and abdominal fat mass by approximately 2 kg, and this effect is more pronounced in women and young individuals.
Effects of Exercise Types:
- Aerobic Exercise (AE): Increases calorie burn and promotes cardiovascular health.
- Resistance Training (RT): Preserves muscle mass and increases basal metabolic rate.
- AE + RT: The most effective combination in terms of fat loss and muscle mass preservation.
Importance of Daily Physical Activity
In addition to regular exercise programmes, physical activities performed in daily life (e.g. climbing stairs, housework, walking) provide an important support in obesity management by increasing energy expenditure. In this context, non-exercise activity thermogenesis (NEAT) is an important component of total daily energy expenditure. NEAT has the potential to increase energy expenditure even in individuals who do not exercise regularly and is one of the main reasons for differences in daily energy expenditure between individuals.
For example, one study observed that working on a treadmill at low speed (approximately 1.1 mph) in the work environment of desk workers increased energy expenditure from 72 kcal to 191 kcal per hour. Such small changes can result in energy expenditure equivalent to 10-15kg of fat loss on an annual basis.
Importance of Physical Activity After Bariatric Surgery
Although bariatric surgery is an effective method in the treatment of obesity, it requires lifestyle changes for the sustainability of weight loss. Increasing physical activity is the most important of these changes.
When to Start Exercising After Bariatric Surgery?
The time to start exercising may vary depending on the type of surgery, the general health status of the patient and the recovery process after surgery. However, general recommendations are as follows:
1. First 2-4 Weeks:
- This period is a critical period for the healing of postoperative stitches and recovery of the body. Heavy exercises should be avoided during this period.
- Light walks are recommended. For example, 5-10 minute walks several times a day are beneficial to increase blood circulation and prevent complications due to immobility.
2. 4-6 Weeks After:
- With the approval of the surgeon, low-impact aerobic exercises can be started. For example, stationary cycling, swimming and light brisk walks may be preferred.
- Resistance exercises such as weight lifting should be avoided during this period.
3. After the 6th week:
- In general, most patients can start more regular and varied exercise programmes during this period.
- Options such as light resistance exercises, weight training and group fitness activities can be considered.
Increasing NEAT in the postoperative period is also important in weight management. Increasing daily activities supports long-term weight control and improves quality of life.
In obesity management, physical activity is a powerful tool for individuals to maintain energy balance, reduce metabolic risks and improve quality of life. Aerobic exercise, resistance training and NEAT, when used together, offer a comprehensive approach to combating obesity. For individuals undergoing bariatric surgery, exercise is critical to prevent muscle loss and sustain weight loss in the postoperative period. Integrating NEAT into the daily routine facilitates weight management while enabling individuals to move away from sedentary lifestyles.
