Motivating increases in physical activity to prevent recurrence of weight gain after metabolic bariatric surgery: The Exercise Values of Life and Vitality Everyday (EVOLVE) trial

IF 1.9 3区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Contemporary clinical trials Pub Date : 2025-10-02 DOI:10.1016/j.cct.2025.108098

Dale S. Bond , Pavlos K. Papasavas , Yin Wu , Michael E. Levin , Shira I. Dunsiger , David B. Sarwer , Leah M. Schumacher , Dahlia Saad-Pendergrass , Anna Schwartz , Jason Lillis

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引用次数: 0

Abstract

Background

Recurrence of significant weight gain after metabolic and bariatric surgery (MBS) is common and can lead to physical and psychological complications. Although patients are encouraged to increase moderate-to-vigorous intensity physical activity (MVPA) to prevent weight recurrence, many report low motivation. This study tests whether targeting autonomous motivation through an Acceptance and Commitment Therapy (ACT)-based intervention can produce durable increases in MVPA to prevent postoperative weight recurrence.

Study design

A total of 164 adults who are 6–20 months post-MBS with stable weight (<10 % regain from maximum weight loss) are randomly assigned to one of two 12 months programs: an ACT intervention (Physical Activity [PA]-ACT) or a contact-matched education control (PA-EDU). PA-ACT uses values clarification and acceptance strategies to foster autonomous motivation for self-determined MVPA goals. PA-EDU provides didactic instruction on PA, related health topics, and cognitive-behavioral strategies for prescribed MVPA goals. Both conditions receive group-based workshops and individual counseling delivered via video conferencing and email micro-interventions. The conditions will be compared on changes in MVPA and weight recurrence (primary outcomes) and autonomous motivation and acceptance (secondary outcomes) from baseline to 12 months (end-of-treatment) and 18 months (follow-up). Mediators of MVPA (motivation, acceptance) and weight recurrence (MVPA) will also be explored.

Conclusion

This is the first study to examine whether an ACT-based intervention can foster autonomous motivation for sustained MVPA to prevent weight recurrence after MBS. The results may inform more robust guidelines for PA in MBS and support integration of these strategies into clinical practice to prevent significant weight recurrence.

ClinicalTrials.gov Registration: NCT037604.

查看原文本刊更多论文

促进增加身体活动以防止代谢减肥手术后体重增加的复发：每日生命和活力的运动价值（EVOLVE）试验。

背景：代谢和减肥手术（MBS）后体重明显增加的复发是常见的，并可导致身体和心理并发症。尽管鼓励患者增加中等至高强度的体育活动（MVPA）以防止体重复发，但许多患者报告缺乏动力。本研究测试是否通过基于接受和承诺治疗（ACT）的干预靶向自主动机可以产生持久的MVPA增加，以防止术后体重复发。研究设计：164名MBS后6-20 个月体重稳定的成年人(结论：这是第一个研究基于act的干预是否可以促进持续MVPA的自主动机，以防止MBS后体重复发的研究。研究结果可能会为MBS患者的PA提供更强有力的指南，并支持将这些策略整合到临床实践中，以防止体重明显复发。临床试验：gov注册：NCT037604。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Contemporary clinical trials 医学-药学

CiteScore

3.70

自引率

4.50%

发文量

281

审稿时长

44 days

期刊介绍： Contemporary Clinical Trials is an international peer reviewed journal that publishes manuscripts pertaining to all aspects of clinical trials, including, but not limited to, design, conduct, analysis, regulation and ethics. Manuscripts submitted should appeal to a readership drawn from disciplines including medicine, biostatistics, epidemiology, computer science, management science, behavioural science, pharmaceutical science, and bioethics. Full-length papers and short communications not exceeding 1,500 words, as well as systemic reviews of clinical trials and methodologies will be published. Perspectives/commentaries on current issues and the impact of clinical trials on the practice of medicine and health policy are also welcome.