Exploring Methods of Adjusting VO₂max for Body Size to Estimate Aerobic Capacity in People Presenting for Metabolic and Bariatric Surgery

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2025

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Dostan, R.
Slayman, S.
Durey, B.
Tarca, B.
Bessell, J.
Davison, K.

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Obesity Science & Practice, 2025; 11(6):e70105-1-e70105-7

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Rebecca Dostan, Sara Slayman, Belinda Durey, Brett Tarca, Justin Bessell, Kade Davison

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BACKGROUND: In perioperative settings exercise testing can be used to assess a patient's physical fitness, with VO₂max used as a marker to indicate fitness and subsequent risk of adverse surgical outcomes. However, the commonly used reporting methods of VO₂max may be problematic in populations with excessive FM such as those awaiting MBS for obesity. Hence, alternative ways of expressing VO₂max will be explored. METHODS: Historical data from individuals presenting for MBS were analyzed. Predicted VO₂max values were adjusted relative to the participants measured and "normative" body mass, where each prediction was assigned a classification score. Predicted VO₂max adjusted to the participants measured FFM was also considered. Data were compared to individuals that are lean and sedentary as well as those with obesity from a previous study. RESULTS: Data from 20 participants awaiting MBS (43.15 ± 11.82 years, 68.50 ± 8.39 cm, 115.29 ± 16.82 kg and 59.93 ± 8.69 kg FFM) were examined. Predicted VO₂max relative: to total mass was 20.15 ± 5.00 mL/kg/min; normative body mass was 30.04 ± 6.58 mL/kg/min; and FFM was 38.55 ± 9.08 mL/kg FFM/min. Median fitness classifications increased from very poor to poor when predicted VO₂max was expressed relative to normative body mass. CONCLUSIONS: Reporting predicted VO₂max results relative to body mass may be underestimating fitness and overestimating surgical risk in people who are very obese.

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© 2025 The Author(s). Obesity Science & Practice published by World Obesity and The Obesity Society and John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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