Abstract
Background and Purpose: Sleeve gastrectomy is a major therapy of morbid obesity, but recent reports suggest that its effects on weight loss are improved when patients increase their muscular activity, while a weight regain may occur in more than 30% of patients after 40 months. Exercise is an effective mean of preventing weight regain. In a recent preliminary study, we reported that exercise training targeted at the level of maximal lipid oxidation (LIPOXmax) improved weight loss and weight stabilization at 30 months. This study extends this previous one and aims at describing the kinetics of weight loss on 60 months after sleeve in people performing or not a LIPOXmax training and to see whether this variety of training exerts a satietogenic effect in sleeve patientsas has been evidenced in nonoperated obese subjects.Methods: We present a longitudinal study of sleeve associated or not with regular exercise prescribed and followed over 60 months. Two groups of obese patients matched for baseline BMI and age were compared. The first group was treated by sleeve gastrectomy alone and patients did not increase their muscular activity. The second group practiced 3x45 min/week endurance exercise targeted at the level of maximal lipid oxidation (LIPOXmax) after sleeve gastrectomy.Findings: In a series of 43 patients (splitted into two matched subgroups, 20 trained, and 23 untrained) we confirm that LIPOXmax training associated to sleeve induces a greater weight loss than sleeve alone (p=0.001). In a subset of 10 subjects (6 women and 4 men) we show that the first sessions of of training decrease all items related to hunger (p<0,05) and increase satiety (p<0,05). However, the intensity of these effects is lower than previously observed in nonoperated obese subjects.Conclusion: Therefore, the long lasting, moderate, and slightly progressive weight-reducing action of LIPOXmax endurance training is observed after sleeve gastrectomy and synergistically adds its effect to that of surgery. This effect is associated with a decrease in orexigenic drive and an improvement of satiety.