The aim of this project is to understand the impact of a structured personalised 4-week exercise programme on resting fitness and metabolic rate in patients awaiting bariatric surgery for obesity. The hypothesis is that patients awaiting bariatric surgery who undertake a preoperative exercise programme will experience attenuated changes in functional capacity and metabolic rate compared with usual care (no exercise programme) along with alterations in autonomic control and medium-term postoperative weight loss.~The investigators propose a randomised controlled trial that will recruit 70 patients with obesity scheduled for bariatric surgery at UCLH, Whittington Health NHS Trust, and Homerton University Hospital NHS Foundation Trust. Participants will be randomly assigned to either usual care (exercise advice only) or combination exercise intervention group, during a four-week lead up to surgery, on a 1:1 basis.~Participants randomised to the intervention group will participate in 7 physiologist-led exercise sessions online and also be instructed to complete seven self-led 30-minute exercise sessions over the four-week intervention period. This equates to a total of 14 exercise sessions across the four-week (28 day) intervention. Additionally, participants will be encouraged to be physically active on as many days as possible, in bouts of 10-minutes or more. The programme is designed to meet the National Physical Activity Guidelines of at least 150 minutes of low-moderate or 75 minutes of vigorous PA per week, or a combination of the two.~The investigators will measure physical fitness, metabolic rate, and how the heart responds to hormonal changes (the sympathetic nervous system) in all participants, before and after the four-week study period. The investigators will also follow each participant's journey through surgery and determine whether the exercise intervention led to differences between the two groups after surgery in terms of weight loss. The investigators will also interview participants about their participation in the study in regard to the planning of future studies.~Baseline data collection will occur approximately six weeks prior to surgery as detailed below. Both groups will be invited to attend follow-up assessment at 4 weeks where they will undergo the same series of tests. Post-surgery, at 12 weeks and 24 weeks, participants will be invited to attend follow-up assessment where body weight will be measured. The post-operative testing visits will be aligned with scheduled hospital follow-up appointments. The total duration of participation will be approximately 32 weeks (six weeks preoperatively to six months (26 weeks) postoperatively).
The aim of this project is to understand the impact of a four week preoperative exercise programme on fitness and metabolic rate and weight before surgery and weight after surgery.~A single-site randomised trial at UCLH, recruiting patients awaiting bariatric surgery for obesity at UCLH, Whittington Health NHS Trust, or Homerton University Hospital NHS Foundation Trust.~The investigators will measure fitness, metabolic rate, body weight/composition and grip strength in all participants, before and after a four-week supervised physical activity intervention. The investigators will follow each participant's journey through surgery and determine whether the exercise intervention led to differences between the weight of the two groups after surgery. The investigators will also interview participants about their participation in the study in regard to the planning of future studies.