Abstract

Limited research exists on the effectiveness of pre-surgery wellness programs on post-surgical health behaviors for bariatric surgery candidates. The purpose of this study was to determine the impact of a pre-bariatric surgery wellness coaching program on levels of physical activity (PA), dietary habits, and health-related quality of life (HRQoL). Questionnaires were distributed to all patients who underwent bariatric surgery and/or participated in a twelve-week weight loss wellness coaching program during the years 2009 to 2012 (n = 782). From the 118 returned surveys (15.0%), 102 participants (age = 51.43 ± 12.98 years, BMI = 29.34 ± 5.72 kg m-2) were placed in either the wellness coaching group (intervention, n = 44) or surgery only group (control, n = 58) on the basis of whether they participated in, and completed, the twelve-week program. Wellness coaching participants who elected not to have surgery were excluded from this study (n = 16). Weight (self-reported), weight loss (self-reported), PA (7-day IPAQ-short), exercise motivation (BREQ-2), dietary adherence, a pre- and post-caloric comparison, and HRQoL were analyzed. Although researchers recognize self-reported weight, weight loss and PA via the IPAQ-short may have limitations in this population, significant differences were found. Pre-surgical body mass index (45.97 ± 7.56 v. 45.52 ± 6.67 kg m-2, t(100) = -0.32, p = .75) and time since surgery (28.05 ± 15.53 v. 34.87 ± 20.96 months, t(100) = 1.82, p = .07), were not statistically different between groups. Compared to controls, participants in the wellness coaching group had significantly more weekly vigorous PA time (264.14, ± 472.33 v. 100.17 ± 163.95 min, t(100) = -2.46, p = .02) and total minutes of moderate to vigorous PA time (501.30 ± 544.87 v. 293.88, ± 445.50 min, t(100) = -2.11, p = .04), and total weekly PA energy expenditure (4759.58 ± 5454.9 v. 2877 ± 3043.14 MET min., t(100) = -2.22, p = .03). Significant differences were also found for identified regulation (2.87 ± 0.79 v. 2.22, ± 0.98, t(100) = -3.06, p <.0001); intrinsic regulation (2.39 ± 0.93 v. 1.69 ± 1.15, t(100) = -3.33, p = .001); and vitality scores (67.05 ± 20.72 v. 55.17 ± 23.77, t(100 ) = -2.64, p = .010). Participation in a pre-surgery wellness coaching program produced higher PA, exercise motivation, and HRQoL following bariatric surgery compared to not having received coaching.