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Associations between physical activity and changes in depressive symptoms and health-related quality of life across 7 years following roux-en-y gastric bypass surgery--a multicenter prospective cohort study

Authors: King, Wendy C. PhD; Hinerman, Amanda S. MPH; White, Gretchen E. PhD; Courcoulas, Anita P. MD; Belle, Steven H. PhD

Summary:

Objective: To examine associations of objectively measured free-living physical activity (PA) with changes in depressive symptoms and mental and physical health-related quality of life (HRQoL) over 7 years following Roux-en-Y gastric bypass surgery (RYGB).

Background: The contributions of PA to improvements in mental and physical health following RYGB, independent of weight loss, are unclear.

Methods: Adults undergoing RYGB in a US multi-center cohort study wore an activity monitor and completed the Beck Depression Inventory (BDI) and 36-Item Short Form Health Survey (SF-36) annually ≤7 years (N = 646; 78% female, median age 47 years, median BMI 46 kg/m2). Linear mixed models estimated associations of quartiles of steps, sedentary behavior (SB), and moderate-to-vigorous intensity physical activity (MVPA), respectively, with pre-to-post-surgery changes in the BDI and SF-36 Mental Component Summary (MCS) and Physical Component Summary (PCS) scores, respectively, over 1–7 years post-surgery, with adjustment for sex, age, race, pre-surgery body mass index, the respective pre-surgery score, treatment for depression (time-varying) and pre-to-post-surgery weight change (time-varying).

Results: There were dose-response associations between steps, SB (inverse) and MVPA quartiles, respectively, with improvements in each score. Across follow-up, mean improvements in the BDI, MCS and PCS scores, were 1.9 (95%CI, 1.0–2.8), 3.1 (95%CI, 1.5–4.7), and 4.0 (95%CI, 2.7–5.4) points higher, respectively, in the highest versus lowest steps quartile.

Conclusion: Among adults who underwent RYGB, multiple objective PA measures were associated with decreases in depressive symptoms and improvements in mental and physical HRQoL throughout 7 years, independent of weight loss, indicating PA is a modifiable behavior to augment outcomes.

Source: Annals of Surgery, November 24, 2020