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. 2021 Sep 2;8(2):164-175.
doi: 10.1002/osp4.558. eCollection 2022 Apr.

Associations of physical activity and sedentary behavior with appetite sensations and eating regulation behaviors before and during the initial year following bariatric surgery

Dale S Bond  1 , Kathryn E Smith  2 , Leah M Schumacher  1 , Sivamainthan Vithiananthan  3   4 , Daniel B Jones  5 , Jennifer Webster  1 , J Graham Thomas  1
Affiliations

Associations of physical activity and sedentary behavior with appetite sensations and eating regulation behaviors before and during the initial year following bariatric surgery

Dale S Bond et al. Obes Sci Pract. .

Abstract

Background: Bariatric surgery produces weight loss in part by impacting appetite and eating behavior. Research suggests physical activity (PA) assists with regulation of appetite and eating during non-surgical weight loss, although whether PA carries similar benefits in the context of bariatric surgery is unknown.

Objective: Evaluate associations of moderate-to-vigorous intensity PA (MVPA) and sedentary time (ST) with appetite sensations (hunger [homeostatic/hedonic], satiety) and eating regulation behaviors (restraint, disinhibition) before and during the initial year following bariatric surgery.

Method: Adult bariatric patients received an accelerometer to measure MVPA/ST and a smartphone to complete appetite/eating ratings at four semi-random times daily for 10 days at pre- and 3-, 6-, and 12-months post-surgery. Data were analyzed using generalized linear mixed models.

Results: Higher MVPA levels related to more satiety across time (p = 0.045) and more restraint at 3-months post-surgery (p < 0.001). At pre-surgery, higher MVPA levels also related to more disinhibition (p's < 0.01), although participants reported more disinhibition on days they performed less MVPA than usual (p = 0.017). MVPA did not relate to hunger. Lower ST levels related to more hedonic hunger (p = 0.003), especially at 12-months post-surgery (p < 0.001), and participants reported more homeostatic hunger on days they accumulated more ST than usual (p = 0.044). Additionally, higher ST levels related to more disinhibition at 3-months post-surgery (p's < 0.01) and lower restraint at pre-surgery (p's < 0.05). ST did not relate to satiety.

Conclusions: This study is the first to show that MVPA and ST each associate with appetite and eating regulation in daily life before and during post-surgical weight loss. Results, while preliminary and requiring experimental confirmation, highlight potential for targeting bariatric patients' activity behaviors to enhance modulation of appetite, control of food intake, and resistance to overeating.

Keywords: appetite; bariatric surgery; eating; physical activity; sedentary behavior.

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Conflict of interest statement

Dale S. Bond, J. Graham Thomas, Sivamainthan Vithiananthan, Daniel B. Jones, and Leah M. Schumacher report funding from NIH during the course of the study. Kathryn E. Smith and Jennifer Webster have nothing to disclose.

Figures

FIGURE 1
FIGURE 1
Interaction of time since surgery and between‐ or within‐participant MVPA predicting restraint (A) and disinhibition (B‐C). MVPA, moderate‐to‐vigorous intensity physical activity; Red, blue, and green dots indicate low (−1 SD), mean, and high (+1 SD) of MVPA (respectively)
FIGURE 2
FIGURE 2
Interaction of time since surgery (months) and between‐person sedentary time predicting (A) Hedonic hunger, (B) restraint, and (C) disinhibition. Red, blue, and green dots indicate low (−1 SD), mean, and high (+1 SD) of sedentary time (respectively)
See this image and copyright information in PMC

References

    1. Arterburn D, Wellman R, Emiliano A, et al. Comparative effectiveness and safety of bariatric procedures for weight loss: a PCORnet cohort study. Ann Intern Med. 2018;169(11):741‐750. - PMC - PubMed
    1. English WJ, DeMaria EJ, Brethauer SA, Mattar SG, Rosenthal RJ, Morton JM. American Society for Metabolic and Bariatric Surgery estimation of metabolic and bariatric procedures performed in the United States in 2016. Surg Obes Relat Dis. 2018;14(3):259‐263. - PubMed
    1. Mechanick JI, Apovian C, Brethauer S, et al. Clinical practice guidelines for the perioperative nutrition, metabolic, and nonsurgical support of patients undergoing bariatric procedures – 2019 update: cosponsored by American Association of Clinical Endocrinologists/American College of Endocrinology, The Obesity Society, American Society for Metabolic and Bariatric Surgery, Obesity Medicine Association, and American Society of Anesthesiologists. Obesity (Silver Spring). 2020;28(4):O1‐O58. - PubMed
    1. Courcoulas AP, Gallagher JW, Neiberg RH, et al. Bariatric surgery vs lifestyle intervention for diabetes treatment: 5‐year outcomes from a randomized trial. J Clin Endocrinol Metab. 2020;105(3):866‐876. - PMC - PubMed
    1. Schauer PR, Bhatt DL, Kirwan JP, et al. Bariatric surgery versus intensive medical therapy for diabetes – 5‐year outcomes. N Engl J Med. 2017;376(7):641‐651. - PMC - PubMed

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