Fitness Book a Win–Win for Bariatric Patients Before and After Surgery

| October 1, 2019

by Scott T. Jamieson, MS, ACSM-EP

Mr. Jamieson is the Metabolic Phenotyping Laboratory Manager for the Obesity Institute/Center for Nutrition Weight Management at Geisinger Medical Center, Danville, Pennsylvania.

Funding: No funding was provided

Disclosures: The author has no conflicts of interest relevant to the content of this article.

Bariatric Times. 2019;16(10):18.


Recently, I had the opportunity to review a unique book titled Bariatric Fitness—For Your New Life, authored by fitness professional Julia Karlstad. Surely, when it comes to surgical weight loss and long-term weight management, the three major domains of any major weight loss success story are exercise, dietary restriction, and, in some instances, pharmacotherapy. However, when offering proper prescription of exercise to this patient population, most clinicians reiterate current guidelines set forth by leading exercise and physical activity authorities. What is regularly neglected to be addressed are the presumptive questions, “What type of activities are appropriate?” “What is an adequate intensity at which to exercise?” and “Where does one begin with all of this?” There are right and wrong ways to do just about everything, including how to exercise appropriately and safely. Unfortunately, the curriculum of most medical school programs does not require exercise physiology or sports medicine courses to graduate, which can limit the practicing physician who treats patients with obesity in regard to exercise recommendations. To effectively promote exercise in bariatric patients, practicing physicians need a comprehensive reference guide on the specifics of exercise; thus, bringing us to Karlstad’s book.

Serving as a basis for both bariatric patients and weight management physicians, Karlstad’s book has encompassed all facets of health and well-being in a relatable format for patients considering bariatric surgery and for those who have already undergone the procedures. Prioritizing the outline of the book, Karlstad first addresses the readers on the importance of mindset and how it pertains to physical activity and exercise. Many bariatric patients might consider exercise to be an arduous endeavor, which can throttle their initial interest and motivation to engage in this healthy lifestyle modification. However, as addressed in the first two chapters of the book, Karlstad’s position on “getting the mind right” before exercise couldn’t ring more true. By shifting our thoughts and emotion processing, we can internally prime our bodies for acceptance of change, which allows us to focus on the present and change our old habits.

Karlstad sheds light on the proper warm-up exercises with mobility work, how to assess relative exercise intensity, and the primary domains of structured exercise. Specifically, the most appealing part of Karlstad’s book is the variance she provides with illustrations of weight-bearing exercises. Equipment availability is a common barrier to exercise for most individuals and is compounded by functional limitations often present in the bariatric population. By highlighting foundational exercises that can performed using one’s bodyweight or with a set of free weights, the equipment barrier is essentially removed. Most importantly, long-term progression is also addressed in both the cardiovascular and weight-bearing aspect of exercise through the provided regimented programs. Research has shown that regular engagement in exercise is a key component to long-term weight management following bariatric surgery; therefore having a tenable, evidence-based program to follow is crucial.

This book is a win-win for the bariatric community. Patients are educated on proper forms of exercise and how this pertains to their specific medical profile. Physicians can be confident that their patients will know how to exercise safely and effectively. For patients considering bariatric surgery or who have had the surgery, Karlstad’s comprehensive resource on exercise and well-being is a must-read for long-term success in one’s weight loss journey.

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Category: Book Reviews, Current Issue

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