Amanda: Hello everyone, welcome back to our third segment of today’s interview with Dr. Botezelli on Bariatrics and Exercises. What are the most recommended exercises from your practice that you recommended to Bariatric patients either before they have the surgery or after they had the Bariatric surgery? Dr. Botezelli: So, I like to compare our muscles to an elastic (when you pull it in the beginning it is pretty easy, then it starts to get harder, that is our body). If you are starting to exercise right now, it's like a new thing that you want to change your life, so you're doing the Bariatric surgery and then you decide to do exercise, every kind of exercise that you do, will produce good results in your body, tremendous results. If you talk about an athlete, they train a lot, so the elastics pulled all the way, so it's super hard to get improvements. But in the beginning, if you are sedentary, if you don't exercise that much, anything you do will produce really good results and fast results, so we see improvements by 30-40% of strength and endurance in 1-2 months, it is pretty fast, our body would adapt pretty fast. The point here is you need to do both endurance and strength exercise. The strength exercise will help you to keep your muscles, to make the muscles grow, to make the muscles bigger, even though you are in a caloric restriction, you are keeping your muscles. And this is important, because remember, in the two previous topics of this interview, when you do the Bariatric surgery, usually you lose a lot of muscle, so when you build this muscle before and after the surgery, you are increasing your metabolism, you are increasing the capacity of your muscle to generate power and burn calories. The endurance exercise is pretty important because of two things: first, endurance exercise (when I say endurance, I say biking, elliptical, running, swimming, even walking, you don’t need to start running), it burns a lot of calories and most of the calories from fat, so it will reduce your triglycerides, it will improve your cholesterol in your blood, and also you prepare your body to get more oxygenated, so you produce more red cells, you get better quality of your blood, your blood will carry more oxygen, this is amazing before the surgery and after the surgery to recovery. We need oxygen to activate our metabolism and help with the regeneration of your body. Both exercises are great (we need both endurance and strength exercises) they are quit of mandatory before and after the surgery, because this way you keep your muscles and you spend more energy and you will affect your metabolism to prepare you for the surgery and to prepare you for a new routine and new life after the surgery. Amanda: Great point! Please, clarify to our listeners/viewers with more examples as a lot of people don’t understand the word cardio and the difference between endurance and strength exercises before and after Bariatric surgery. Dr. Botezelli: Endurance or cardio, is the exercise that you do for a very long time, because you have to sustain this exercise for a very long time, it is a lower intensity, so your body needs to get more efficient and break the energy, the substrates, fat, carbohydrates in a really good efficient way. So, if you need to run 1 kilometer, for example, or walk for 1 kilometer, usually, because it is a lower intensity exercise, your body will need to break down more fat, so this way you will burn more fat. “Ok Diego, if burning fat is a good way and I want to lose fat, should I do endurance exercise all the time?” Not all the time, because endurance exercise will make your body more efficient, you won’t grow muscle, because the amount of muscle that you have, with that muscle, you can walk for like five, 10, 20 kilometers, so your body will not try to grow your muscle.
