Exercise after a sleeve: a gentle start, month by month

Moving your body is one of the habits that matter a lot after a gastric sleeve. It helps you keep your strength while you lose weight, supports your heart, mood and sleep, and makes everyday life easier. What counts is a gentle start and small steps up. Here is how activity often grows over the first months. Your care team confirms each step for you.

Week 1: short walks

Walk as soon as you are home, and a little more each day. Short walks around your home or outside help prevent blood clots, ease gas pain and lift your energy. Many people build up to about 20 minutes, twice a day, by the end of the first week. Go at a pace where you can still talk easily.

Weeks 2 to 4: light exercise

With your team's OK, you can add gentle moves that build strength and flexibility, such as stretching, leg lifts, shoulder rolls or beginner yoga. Keep walking every day, and make your walks a little longer or a little more frequent.

• Nothing heavier than about 10 lb (4.5 kg) until your surgeon clears you.
• No sit-ups, crunches or planks yet. Your belly muscles and incisions need time to heal.
• No swimming, baths or hot tubs until your incisions have healed and your surgeon says so.

Weeks 4 to 8: more cardio

Your surgeon usually checks how you are healing a few weeks after surgery. Once you are cleared, you can start to raise your heart rate with brisk walking, cycling, an elliptical or, once your incisions have healed, swimming. A good goal for this stage is about 30 minutes of moderate cardio, 3 times a week. Moderate means you breathe harder but can still talk.

You are still eating very little, so your energy can run low. Sip fluids before and after activity, keep sessions short at first and stop if you feel dizzy or weak.

From week 8: strength training

Strength training helps you hold on to muscle while you lose weight. Start light, with your own body weight, light hand weights or resistance bands, and build up slowly. Sitting down to a chair and standing up again, lunges, wall push-ups and step-ups are good places to start. Aim for 2 to 3 sessions a week, with a rest day in between.

Learning the right form early helps you avoid injury. A physiotherapist, a kinesiologist or a certified trainer who knows about bariatric surgery can show you how.

From month 3: your long-term routine

Around 3 months after surgery, gentle core and abdominal exercises can usually start. From here, activity becomes part of your everyday life.

• Canadian guidelines for people after bariatric surgery suggest 150 to 300 minutes of activity a week over the long term.
• Canadian movement guidelines for adults add muscle-strengthening activities at least twice a week, several hours of light activity such as standing, and limiting sitting time to 8 hours or less a day.

What does exercise add? A 2021 review of controlled trials found that exercise training after bariatric surgery improved fitness and muscle strength and led to a small extra weight loss, about 1.8 kg on average. Early evidence suggests it may also help protect bone and help people keep weight off.

Choose activities you enjoy, so you keep doing them: walking with a friend, dancing, cycling, swimming, a class or a sport. A fitness tracker or a simple notebook can help you see your progress.

When to stop and call your team

Stop and call your care team if activity brings on any of these:

• Chest pain or pressure.
• Dizziness or feeling faint.
• Shortness of breath that is unusual for you.
• New belly pain, or pain around your incisions.
• Pain, swelling or warmth in one leg.

For chest pain or trouble breathing, call 911.