Exercise Following Bariatric Surgery for Severe/Morbid Obesity (EFIBAR)

%TWL = [(pre-surgery weight - post-surgery weight) / (pre-surgery weight)] x 100

Percent body fat (%) assessed by bioimpedance analysis (InBody 270, Biospace Co., USA)

Fat-free mass (kg) assessed by bioimpedance analysis (InBody 270, Biospace Co., USA)

Fat-free mass index (kg/m2) assessed by bioimpedance analysis (InBody 270, Biospace Co., USA)

Waist and hip circumferences (measured in cm with an anthropometric tape), waist / height ratio

Total cholesterol (mg/dl), HDL-cholesterol (mg/dl), LDL-cholesterol (mg/dl) and triglycerides (mg/dl)

Glucose (mg/dL)

Insulin (μUI/mL)

Homeostasis Model Assessment of Insulin Resistance (HOMA-IR)

Glycated hemoglobin HbA1c (%)

Systolic and diastolic blood pressures assessed by Mobil-O-Graph

Pulse wave velocity (PWV, m/s) by Mobil-O-Graph

High-sensitivity C-reactive protein (hs-CRP)

Tumor necrosis factor (TNF-alpha)

Interleukin 6 (IL-6)

GGT (gamma-glutamyltransferase)

GPT (glutamate-pyruvate transaminase)

GOT (glutamate-oxalacetate transaminase)

Concentrations of 25-hydroxyvitamin D (ng/mL)

Assessed by heart rate monitor (Polar V800)

Cardiorespiratory fitness, assessed using a maximal treadmill test

Upper body muscular strength, assessed using handgrip dynamometry (kg)

Lower body muscular strength, assessed using the 30-seconds chair-stand test (number of repetitions)

Upper body flexibility, assessed using the back scratch test (cm)

Assessed by accelerometry (ActiGraph, software ActiLife)

Measured by the 36-item Short Form Health Survey (SF-36)

Measured by European Quality of Life - 5 Dimensions-3Levels (EQ-5D-3L)

Measured by the WOMAC (Western Ontario and McMaster Universities) Osteoarthritis Index. The PAIN scale within the WOMAC questionnaire contains 5 items, each one scoring from 0 (Nothing) to 4 (Very much), what makes a total score ranging from 0 (better) to 20 (worse).

Measured by the WOMAC (Western Ontario and McMaster Universities) Osteoarthritis Index. The FUNCTION scale within the WOMAC questionnaire contains 17 items, each one scoring from 0 (No trouble) to 4 (Very much difficult), what makes a total score ranging from 0 (better) to 68 (worse).

Measured by the WOMAC (Western Ontario and McMaster Universities) Osteoarthritis Index. The STIFFNESS scale within the WOMAC questionnaire contains 2 items, each one scoring from 0 (Nothing) to 4 (Very much), what makes a total score ranging from 0 (better) to 8 (worse).

Measured by the Depression, Anxiety and Stress Scale short form (DASS-21). The DASS-21 comprises three sub-scales assessing specific psychiatric symptoms (i.e., depression, anxiety, and stress). Each of these symptoms is assessed using seven items rated on a 4-point Likert-type scale (i.e., 0 = ''Did not apply to me at all''; 3 = ''Applied to me very much, or most of the time''). Summed score for each psychiatric symptom ranges from 0 to 21. Higher scores in each sub-scale indicate higher levels of depressive, anxiety or stress symptomatology. According to the specific nature of the three psychiatric symptoms assessed by the DASS-21, these are treated independently so that no total score is available.

Measured by the Mental Health Continuum-Short Form (MHC-SF)

The costs will consider those related to the surgery, the exercise program, prescription medication, sick leave, post-surgery complications and readmission rates, time and effort requiring each treatment, as well as possible dietary and informal care costs. Effectiveness will be considered as changes observed in the main clinical outcomes: weight loss and cardiometabolic risk (remission/relapse of hypertension, dyslipidemia and type 2 diabetes).

The costs will consider those related to the surgery, the exercise program, prescription medication, sick leave, post-surgery complications and readmission rates, time and effort requiring each treatment, as well as possible dietary and informal care costs. Utility will evaluate variation in quality of life experienced by participants, computed as changes in quality-adjusted life years (QALY) using SF-36 questionnaire.

The costs will consider those related to the surgery, the exercise program, prescription medication, sick leave, post-surgery complications and readmission rates, time and effort requiring each treatment, as well as possible dietary and informal care costs. Utility will evaluate variation in quality of life experienced by participants, computed as changes in quality-adjusted life years (QALY) using EQ-5D-3L questionnaire.