Effects of Sleeve Gastrectomy and Subsequent Whole-Body Vibration Training on Resting Metabolic Rate and Body Composition: A Pilot Randomized Controlled Trial.

BACKGROUND: Sleeve gastrectomy (SG) leads to rapid weight loss, marked by reductions in fat mass (FM) and lean soft tissue (LST), contributing to a decline in resting metabolic rate (RMR). The role of early exercise and the relationship between body composition and RMR remain unclear. OBJECTIVES: To evaluate early changes in RMR and body composition after SG, explore the effects of a whole-body vibration (WBV) resistance training intervention, and examine associations between RMR and body composition. METHODS: Twenty-six participants with severe obesity (61.5% female, age 40.1 ± 9.1 years, BMI 45.4 ± 4.8 kg/m²) were assessed pre-surgery (T1), 7 weeks post-surgery (T2), and 6 months post-surgery (T3). Participants were randomised to 16 weeks of WBV training or usual care. Body composition (DXA) and RMR (indirect calorimetry) were measured. RESULTS: SG induced significant reductions in LST (-7.81 kg) and FM by T2, with a decline in absolute RMR (-357.7 ± 164.3 kcal/day). The WBV group showed mitigated loss of appendicular LST (ALST) and ALST index from T2 to T3. Over the entire study period (T1-T3), the reduction in RMR was 20% smaller in the WBV group (-430.6 vs. -536.3 kcal/day); however, this difference did not reach statistical significance (p = 0.085). Cross-sectionally, LST parameters were associated with RMR at all timepoints (R²=0.66-0.81), and baseline LST parameters predicted postoperative RMR. CONCLUSION: In this pilot trial, early WBV training attenuated losses of appendicular LST following SG. A smaller reduction in RMR was observed in the WBV group; however, this difference did not reach statistical significance and may warrant investigation in larger adequately powered trials. The predictive value of preoperative LST for postoperative RMR highlights the benefit of prehabilitation strategies to improve metabolic outcomes.