The Impact of Abdominal Body Contouring Surgery on Physical Function After a Massive Weight Loss (BCSP)

Participants will be recruited through multiple medical clinics and will visit the exercise, nutrition and muscle metabolism lab twice over the course of 8-12 weeks to complete objective and subjective measures of physical function. Each testing session will be conducted by the study investigator and physical function testing will be video recorded to reduce measurer bias. Based on participants' status they will be allocated to either a body contouring intervention group (BCI) or a post massive weight loss matched control (PMWMC). The first testing session would happen preoperatively and second one would happen between 8-12 weeks postoperatively depending on recovery required. Pain levels will be measured both pre and postoperatively using a numerical rating scale (0-10) to ensure adequate recovery.

Outcomes will include a variety of objective measures of physical function including 9-item modified physical performance test (mPPT), 30 second chair stand, timed up and go, stair climbing power, modified agility t-test, star excursion balance test, and 6 minute walk test. A body composition measure consisting of fat mass and fat free mass will also be obtained via dual-energy X-ray absorptiometry. Subjective measures would include 6 components of health related quality of life measure using BODY-Q questionnaire that would include sub scales such as body image, physical function, psychological, sexual, social, and obesity symptoms. Other subjective measure would include rate of perceived exertion which would be measured during each of the objective tests.

Additionally, grade of excess skin would be measured by images provided to the participants and weight of the resected excess skin will be obtained from the operating surgeon at the end of the study.

To obtain demographic history, physical activity level post surgery and to gain feedback for future clinical trial, the participants will also complete a socioeconomic status questionnaire, physical activity questionnaire, and participant experience with research questionnaire.

Inclusion criteria

• Weight has not deviated by greater than 5 percent for 3 months
• Have excess grade skin of greater or equal to 2
• Percent total weight loss pre-body contouring of greater or equal to 25 percent
• Fluently read and write English

Exclusion criteria

• Any musculoskeletal issues that would prevent participants from doing the physical function tests.
• Current medication history indicating atypical antipsychotics including but not limited to clozapine, olanzapine, quetiapine, risperidone, aripiprazole, amisulpride, ziprasidone, asenapine, iloperidone, lurasidone and paliperidone.
• Severe pulmonary conditions such as severe chronic obstructive pulmonary disease (COPD) and or severe asthma.
• Participants who actively aiming to lose weight
• Have diabetes with diabetic neuropathy or experienced hypoglycemic event within 6 months prior to the study
• Severe kidney disease with estimated glomerular filtration rate (eGFR) less than 60 ml/min
• Pregnant individuals
• Uncontrolled hypertension with resting blood pressure greater than 160/90 mmHg
• Uncontrolled obstructive sleep apnea with symptoms
• On statin therapy with myopathy
• Unstable atrial fibrillation
• Weight pre-body contouring greater than 340 lbs (154 kg)
• Current smoker