Identifying Effective Design Components in Physical Activity Interventions Post‐Bariatric Surgery: A Systematic Review and Meta‐Analysis

ABSTRACT Introduction Poor physical activity (PA) conditions post‐bariatric surgery can negatively affect patient prognosis. The long‐term PA intervention effects are suboptimal, and lacking exploration regarding the dose–response relationship between intervention configurations and outcome. This study aims to explore the association between post‐bariatric surgery PA intervention design components and actual PA improvements. Methods Seven electronic databases were searched. Included were randomized or quasi‐randomized controlled trials post‐bariatric surgery that implemented PA interventions and reported PA levels. Meta‐analyses were conducted for changes in PA and BMI. Subgroup analysis and meta‐regression were performed based on score of consensus on exercise reporting template (CERT), subjective and objective PA reports, intervention type, and intervention‐related timing. Results Out of 11,896 screened articles, 16 were included, totaling 1256 participants. Meta‐analysis results showed significant improvements in PA status at the end of the intervention ( SMD = 0.82, 95%CI 0.25–1.40, p = 0.005), with no significant differences in PA changes at follow‐up times or BMI changes ( p > 0.05). Subgroup analysis indicated that subjective reporting, combined exercise type, starting intervention 1.5 months post‐surgery, and a CERT score ≤7, as well as clear reporting of certain CERT items, enhanced intervention effects. Meta‐regression demonstrated significant associations between CERT score and changes in PA ( β = 0.415, p = 0.038) and BMI ( β = −0.253, p = 0.022) at follow‐up times. Conclusions PA interventions should adopt a training program combining resistance training with aerobic exercise, clearly define training equipment and locations, and provide supervision, motivational strategies, replicable exercise guidance, and training compliance evaluations to enhance the long‐term improvement of PA levels in post‐bariatric surgery patients.