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.

King, Wendy C; Hinerman, Amanda S; White, Gretchen E; Courcoulas, Anita P; Belle, Steven H

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/m). 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.