Physical Activity and Protein Supplementation After Bariatric Surgery (PAPAB)
Physical Activity and Protein Supplementation After Bariatric Surgery (PAPAB)
The purpose of this study is to determine wether regular physical activity in combination
 with protein supplementation after bariatric surgery can reduce the loss of muscle mass and
 wether a computer-assisted exercise program is more effective than a usual exercise program
 regarding frequency of physical activity, fitness and muscular strength.
Bariatric surgery has become a major treatment option for severe obesity in adults. Despite
 the advantages of bariatric surgery, attention needs to be paid to the possible risks
 following the surgical treatment. Postoperative risks include protein deficiency and
 pronounced muscle mass loss. Indeed, numerous studies indicate a significant reduction in
 lean body mass resulting from protein deficiency after bariatric surgery.

 Dietary proteins have shown to play an important role in body weight regulation. A
 protein-rich diet attains satiety and thereby facilitates reduction in overall energy intake.
 It has also shown to enhance food-induced thermogenesis. Furthermore, a protein-rich diet -
 ideally in combination with exercise - preserves lean body mass and thus resting energy
 expenditure leading to an improvement of long-term energy balance. Therefore, protein-rich
 diets or protein supplements, respectively, might facilitate weight loss, especially body fat
 loss and protect against loss in muscle mass in patients who underwent bariatric surgery. The
 aim of the present randomized, placebo-controlled, double blind pilot study was to test the
 possible benefit of proteins in combination with exercise in patients undergoing bariatric
 surgery, and to examine, whether computer-assisted exercise is advantageous when comparing it
 to a usual exercise program using written exercise instructions. Therefore, we study the
 influence of postoperative protein supplementation in combination with computer-assisted
 exercise on body composition changes, and body weight reduction, as well as physical fitness,
 protein status and muscle function in obese patients after bariatric surgery.
Inclusion Criteria:

 -  Age of 18 - 65 years

 -  Body weight of ≤ 150 kg

 -  BMI > 35 kg/m2

 -  Indication for laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric
 bypass. The decision about the type of surgery is performed independent of the study
 by the surgeons in charge according to the German S3 guideline.

 Exclusion Criteria:

 -  Kidney diseases of any kind

 -  Serious gastrointestinal diseases (e.g. Morbus Crohn, Colitis Ulcerosa, etc.)

 -  Serious musculoskeletal diseases

 -  Serious heart diseases (Myocardial infarction, stent implantation, stroke, etc.)

 -  Intake of blood thinning medicine (e.g. ASS, Marcumar, etc.)