Higher preoperative physical activity (PA) strongly predicts higher post-operative PA in bariatric surgery (BS) patients, providing rationale for preoperative PA interventions (PAIs). However, whether PAI-related increases can be maintained post-operatively has not been examined. This study compared PA changes across pre- (baseline, post-intervention) and post-operative (6-month follow up) periods in participants randomized to 6 weeks of preoperative PAI or standard care control (SC). Of 75 participants initially randomized, 36 (PAI n = 22; SC n = 14) underwent BS. Changes in daily bout-related (10-min bouts) moderate-to-vigorous PA (MVPA) and steps were assessed via the SenseWear Armband monitor. PAI received weekly counseling to increase walking exercise. Retention (86%) at post-operative follow up was similar between groups. Intent-to-treat analyses showed that PAI versus SC had greater increases across time (baseline, post-intervention, follow up) in bout-related MVPA minutes/day (4.3 +/- 5.1, 26.3 +/- 21.3, 28.7 +/- 26.3 versus 10.4 +/- 22.9, 11.4 +/- 16.0, 18.5 +/- 28.2; p = 0.013) and steps/day (5,163 +/- 2,901, 7,950 +/- 3,286, 7,870 +/- 3,936 versus 5,163 +/- 2,901, 5,601 +/- 3,368, 5,087 +/- 2,603; p < 0.001). PAI differed from SC on bout-related MVPA at post-intervention (p = 0.016; d = 0.91), but not follow up (p = 0.15; d = 0.41), and steps at post-intervention (p = 0.031; d = 0.78) and follow up (p = 0.024; d = 0.84). PAI participants maintained preoperative PA increases post-operatively. Findings support preoperative PAIs and research to test whether PA changes can be sustained and influence surgical outcomes beyond the initial post-operative period.

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