Supplementary Material for: Resistance training following metabolic-bariatric surgery: motivators, barriers and preferences

Introduction. Metabolic and bariatric surgery (MBS) leads to substantial muscle mass loss. Resistance training (RT) is an effective strategy to maintain muscle mass. This study aimed to gain insight in the motivators, barriers and preferences that are correlated to RT uptake after MBS. Methods. A digital survey assessing RT was sent to patients who had MBS 1 to 18 months prior. Patient characteristics were extracted from electronic health records. Motivators, barriers and preferences were assessed with a questionnaire and compared across three groups: patients currently (RT-group), previously (ex-RT) or never engaged in RT (non-RT). Results. Among 1,609 participants (77% female, 47±11 years old, BMI 42±5 kg/m2) 68% was classified as RT-group, 11% as ex-RT and 21% as non-RT. The RT-group reported improving fitness (78% vs. 67%), mental health (65% vs. 43%) and overall health (63% vs. 41%) more often as motivators for RT than the ex-RT. RT barriers were comparable between ex-RT and non-RT, most frequently: lack of motivation (37% vs. 40%), time (33% vs. 28%), enjoyment (29% vs. 29%) and physical complaints (39% vs. 37%). Ex- and non-RT reported a preferred exercise frequency of 2 sessions/week with 30 minutes/session, in their home setting with a training schedule and guidance from a professional. Conclusion. The majority of participants in our study engaged in RT. We identified improving overall fitness and limiting strength or muscle loss as motivators, lack of motivation, physical complaints, lack of time and enjoyment as barriers, and professional guidance and a training schedule for RT at home as facilitators, that were correlated to RT uptake after MBS.