Is Cardio or Strength Training Better After Bariatric Surgery?

One of the unfortunate realities about our access to the Internet is that there are so many opinions, thought leaders, influencers, and armchair experts who all believe they have the answer to our obesity problem.

I’m both thrilled and scared about the access to information that most bariatric patients have. Elated because the days of only having your care team, a few family members, and an in-person support group have been replaced by a virtually unlimited number of online recipes, peer groups, and advice columns. Scared because I can’t imagine the confusion a bariatric patient must have in the few weeks and months after bariatric surgery when they’re still getting into a groove, but genuinely don’t know whose advice to follow because there are so many differing opinions.

Before we continue discussing the differences between strength training and cardio, all my patients must understand that I am available to them after their procedure. It’s essential to me that they succeed. Ask as many questions as you need to!

Anyone who has had bariatric surgery with me knows that patient selection is critical. I don’t want patients who aren’t ready to have surgery to undergo the procedure, only to fail and regret surgery for the rest of their lives. Instead, I want people who are prepared for the lifestyle changes ahead, because we all win when my patients hit their goals and stay there for the long term – hopefully for the rest of their lives.

So let’s dive right into the suitability of cardio versus strength training, and what to keep in mind about each.

Cardio

Cardio, as the name suggests, is an excellent way to get the cardiovascular system in shape and reduce the long-term risk of heart disease. Cardio is anything that gets your heart rate up for a sustained period. Of course, we’re not including stress or other emotional factors that may also raise your heart rate. Instead, this is physical exertion that is decidedly healthy for your body, despite the higher heart rate.

For post-bariatric patients, the ideal cardio routine starts with low-impact activity, targeting a heart rate of 50-70% of their maximum (approx. 100-130 bpm for many) for 30-60 minutes. However, when first starting out, it’s best to begin with 5-10 minute sessions and gradually build up to 30+ minutes of sustained increased heart rate. There are monitors you can wear, but most smartphones these days have apps that can help you track it.

For most of my patients, I counsel them to start slow, and they typically do not need to go to the gym to get their cardio workout. Once cleared for cardio, vigorous housework, brisk walks, and short jogs can be very beneficial. Later, as patients build endurance and their bodies can handle it, any cardio they wish to perform is usually okay, as long as they do not exert themselves to the point of injury or burnout that halts their exercise routine.

Strength Training

In the early days after bariatric surgery, strength training is off-limits because it can add intra-abdominal pressure that can cause several complications in the stomach and the abdominal wall. However, after about 6 to 8 weeks, once cleared, most patients can start low-level strength training.

Once again, patients can do much of their early strength training at home with some inexpensive dumbbells bought online. Various exercises using your own bodyweight can also help develop different parts of the body and build muscle. Using resistance bands or doing planks are also simple and accessible ways to get in a good exercise session. The point is you want to build muscle in a healthy way with low-impact, compound movements that engage multiple muscle groups.

Strength training is essential for retaining muscle mass as you lose weight and for developing bone density. In doing so, the body burns more calories even at rest, helping you get that much closer to your goal weight and maintaining that weight over the long term.

So which is better? Data shows that ultimately, a combination of strength training and cardio is the best and most optimal way to lose weight after surgery. In the beginning, it’s going to be challenging to do any vigorous activity, and that’s why we always suggest that you ramp up slowly. Of course, the worst thing you could do after bariatric surgery is not do any movement at all.

What might a week of training look like? Aim to do about three sessions of cardio and three sessions of strength training each week, starting with 5-10 minute sessions and building up to 30-60 minutes. You can alternate days if you prefer, or you can combine specific strength-training and cardio days.

For my part, I like the idea of strength training first and cardio later, only because cardio tends to tire you out and you may not be able to do the strength training you want afterward. However, everyone has their own optimal exercise plan, and it’ll take a little bit of trial and error to figure out precisely what that is.

Ultimately, though, if you’re getting out and about, moving your body, and working all of the large muscle groups, you’re on the right track. Even walking consistently is great exercise and easier on the joints than jumping or running. Just don’t forget to keep pushing yourself both physically and mentally to ensure you’re getting the most out of each workout and keeping it interesting.

The Bottom Line

Both strength training and cardio have distinct benefits, and for that reason, they should both be prioritized after bariatric surgery. Ramping up slowly is key to minimizing the risk of complications or injury that can sideline you for weeks or even months.

Just as importantly, and despite all the resources on the Internet, we do want you to consult with us whenever you are in doubt about your exercise program. We can give you advice on getting back on track or maximizing your workouts. Remember, this is a life change, so don’t rush anything.

The needs of each patient drive our work at MIIS Weight Loss Institute. We hold to the fundamental principle of compassionately caring for our patients, especially in times of need. We are grateful to be able to help others in such an important and meaningful way, all while providing a better quality of life for everyone who comes through our office doors. As always, let us know how we can help and anytime you have questions!