Bariatric Surgery and Physiotherapy-led Rehabilitation
This section is designed to give an overarching insight into bariatric surgery and the physiotherapist’s role in supporting adults before and after these surgical procedures.
The PROMINENCE infographic summarises current key surgical options, indications for surgery and
the main rehabilitation considerations across the pre-operative, early post-operative and longer-term recovery phases. Educators can use it to help learners understand how physiotherapy contributes
to optimising outcomes, promoting safety and supporting long-term behaviour change in people undergoing bariatric surgery.
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This infographic can be integrated into lectures regarding obesity management, used as a visual summary when discussing surgical pathways or paired with case-based learning to help students translate this knowledge into safe, effective clinical practice. It is also important for learners to recognise that physiotherapy management in the immediate post-operative phase closely mirrors the principles applied after other abdominal surgeries (e.g. prioritising early mobilisation and preventing common post-operative cardiorespiratory complications such as atelectasis and pneumonia preventing deep vein thrombosis).
Bariatric Surgery and Physiotherapy Infographic
Context for Physiotherapy Practice
Physiotherapists should understand where bariatric surgery sits within the wider obesity-management pathway. For some individuals (BMI<30, with no obesity-related complications), surgery is considered only after structured lifestyle interventions and pharmacotherapy have not provided sufficient or sustainable benefit, or where obesity-related comorbidities remain significant. For other adults with obesity (BMI≥40 or BMI≥35 with obesity complications), bariatric surgery is considered part of the multidisciplinary behavioural or medical management programme. Acknowledging the role of bariatric surgery in obesity management helps learners appreciate that bariatric surgery is part of a broader chronic-disease management approach rather than a stand-alone intervention.
Complications Relevant to Physiotherapy
While the infographic outlines the physiotherapy journey, educators may also wish to highlight key surgical and metabolic complications that can influence rehabilitation planning and monitoring. These may include:
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Gastrointestinal complications: leaks, strictures or obstructions, marginal ulcers, and internal
or incisional hernias. -
Metabolic and nutritional issues: vitamin and mineral deficiencies, protein malnutrition, dehydration, and the development of gallstones.
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Post-operative pain: including abdominal, musculoskeletal or referred pain, which can affect mobility, breathing patterns, and exercise tolerance.
Awareness of these potential complications helps physiotherapy learners understand why careful monitoring, appropriate progression of activity and close collaboration with the multidisciplinary team are essential throughout the patient’s recovery.
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Acknowledgement: Special thanks to Emer O’Malley from the physiotherapy team at the Centre for Obesity Management at St Columcille's Hospital, Loughlinstown, Dublin, Ireland for her input which supported the development of this infographic.
EASO and Obesity UK Infographic on the weight loss maintenance following bariatric surgery: Practical Tips
This infographic, developed by Dr Carly Anna Hughes and Mary O’Kane in collaboration with Obesity UK Directors Sarah LeBrocq and Ken Clare, offers clear, practical guidance to support long-term weight maintenance after bariatric surgery. It highlights the shift from early rapid weight loss to the longer-term phase, typically 12–18 months post-operation, when weight stabilisation becomes the main goal.
For physiotherapy learners this resource is an important reminder that bariatric surgery is only one part of a much wider and ongoing lifestyle-change journey. Long-term success depends on sustained behaviour change across eating patterns, physical activity, sleep, stress management, and self-monitoring. Understanding this broader context helps future physiotherapists see their role as part
of a multidisciplinary team working to support sustainable, health-enhancing routines rather than focusing solely on short-term physical recovery.
The infographic outlines simple, realistic strategies that adults can use to monitor their weight, recognise early signs of weight regain and return to helpful routines before habits become difficult to reverse.
Although many of these strategies relate to nutrition and eating behaviours, all members of the multidisciplinary team (including physiotherapists) benefit from being aware of them. This shared understanding supports consistent messaging, helps identify early challenges, and reinforces coordinated long-term person-centred support that complements the work of other team members.
Educators may find this infographic useful when teaching about behaviour change, the chronic disease model of obesity, or the importance of multidisciplinary support in long-term postoperative care. It also reinforces the physiotherapist’s role in promoting regular physical activity, supporting self-efficacy
and recognising when patients may benefit from referral back to other members of the care team.
By integrating these perspectives, students can appreciate how physiotherapy contributes to sustainable, long-term outcomes beyond the immediate post-operative period.
Developed by Dr Carly Anna Hughes and Mary O’Kane, in conjunction with Obesity UK Directors Sarah LeBrocq and Ken Clare. It is shared with permission from the original content developers for use within the PROMINENCE OER. For more information, please visit easo.org.
Reflection activity for learners: bariatric surgery
and physiotherapy
To enhance learning and clinical reasoning around bariatric surgery and physiotherapy, the following reflective questions are designed to prompt critical thinking and application of knowledge.
These questions encourage learners to consider the entire obesity management pathway, the evolving role of physiotherapy before and after surgery, safety considerations, and the importance of holistic, person-centred care.
Use these prompts to guide individual reflection, group discussion, or as a basis for case-based learning. They will help learners integrate theory with practice and develop a collaborative, patient-focused approach when supporting people through bariatric surgery and rehabilitation.
Reflective Questions for Learners
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Understanding the Clinical Pathway
How does bariatric surgery fit within the broader obesity-management pathway, and why is it important for physiotherapists to understand the progression from lifestyle intervention to pharmacotherapy
to surgery?
In what ways might a patient’s previous attempts at weight management influence your approach
to rapport-building and goal setting?
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Role of Physiotherapy Pre- and Post-Surgery
What are the key contributions physiotherapists make at each stage of the bariatric surgery pathway (pre-operative, early post-operative, long-term rehabilitation)?
How might your physiotherapy goals differ for a person preparing for surgery versus someone several months into their postoperative recovery?
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Clinical Reasoning and Safety
Which surgical complications (gastrointestinal, metabolic, nutritional, or pain-related) would most influence your physiotherapy assessment and monitoring and why?
How would you adapt your intervention if a patient reports new symptoms such as increased abdominal pain, dizziness, or reduced tolerance to activity during rehabilitation?
What vital signs or physical function markers would you prioritise to ensure safe and appropriate progression of exercise?
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Holistic and Person-Centred Care
How can physiotherapists support behaviour change and promote long-term physical activity
in individuals undergoing bariatric surgery?
What strategies can you use to ensure your communication is sensitive, non-stigmatising, and aligned with person-first language?
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Interprofessional Practice
Which members of the multidisciplinary team are most crucial to collaborate with during bariatric surgery management, and what specific information do you need to exchange with them?
This resource was developed for the PROMINENCE Open Education Resource (OER) by physiotherapy senior lecturers
at University College Dublin, Ireland for the Prominence Project.