Table 5.

Behavioral Strategies to Assist Bariatric Surgery Patients Increase and Sustain Physical Activity

Strategy	Application
Goal-setting*	Help patient set incremental weekly goals that are specific, attainable, measurable, and based on patients' initial PA levels
Contracting*	Develop agreement consisting of short-, mid- and long-term goals that reinforces commitment to making permanent PA behavior change
Action planning and tailoring	Ask patients to plan when, where, and how PA will be accumulated throughout each day according to their schedule of activities
Self-monitoring	Provide patient with a pedometer to record daily steps or a diary to record structured PA min (≥ 10-min bouts) to establish baseline PA level and monitor progress
Problem-solving	Teach patients to apply problem-solving strategies (defining problem, brainstorming solutions, choosing, implementing, and evaluating best solution) to overcome barriers to exercise
Social support	Encourage patient to recruit an “exercise buddy,” enlist friends or family members to call and ask about progress toward PA goals, and to assist with childcare if needed
Stimulus control	Encourage patients to add cues to the external environment to promote PA (e.g., extra pair of walking shoes at work, reminder notes) and remove/avoid cues that promote sedentary behavior (e.g., avoid TV room, turn off computer after each use)
Reinforcement	Improve patients' self-efficacy through attainable short-term goals with a high likelihood of success Praise “small successes” and progress towards achievement of PA goals Help the patient identify external rewards for goal achievement (that support PA change) Increase awareness of internal rewards from PA

^*Goal-setting and contracting should first be introduced during the Advise and Agree segments of PA counseling, and then reviewed and revised as necessary when Assisting patients at future appointments.