Trial Outcomes & Findings for Effect of Exercise and Surgical Weight Loss on Polyneuropathy (NCT NCT03617185)

NCT ID: NCT03617185

Last Updated: 2025-10-29

Results Overview

Intraepidermal Nerve Fiber Density (IENFD) as assessed by 3mm skin biopsies at the proximal thigh.

• Recruitment status: COMPLETED
• Study phase: NA
• Target enrollment: 140 participants
• Primary outcome timeframe: Baseline, 3 months, 12 months and 24 months
• Results posted on: 2025-10-29

Participant Flow

Participants were recruited from Bariatric Surgery clinics in Ann Arbor and Detroit.

140 participants were randomized to one of the four arms. Prior to randomization, participants had a screening visit, pre-baseline visit, and baseline visit to confirm eligibility. If participants qualified for the study, they were randomized and moved on with the study.

Participant milestones

Measure	Bariatric Surgery/HIIT High Intensity Interval Training (HIIT) Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months. Procedure/Surgery: Bariatric surgery Patients will undergo bariatric surgery as part of their routine care.	No Bariatric Surgery/HIIT High Intensity Interval Training (HIIT) Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months. Procedure/Surgery: None	Bariatric Surgery/Routine Exercise Routine Exercise Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation). Procedure/Surgery: Bariatric surgery Patients will undergo bariatric surgery as part of their routine care.	No Bariatric Surgery/Routine Exercise Routine Exercise Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation). Procedure/Surgery: None
Baseline STARTED	35	35	35	35
Baseline COMPLETED	35	32	32	32
Baseline NOT COMPLETED	0	3	3	3
3 Months STARTED	35	32	32	32
3 Months COMPLETED	29	28	32	29
3 Months NOT COMPLETED	6	4	0	3
12 Months STARTED	29	28	32	29
12 Months COMPLETED	26	27	28	28
12 Months NOT COMPLETED	3	1	4	1
24 Months STARTED	26	27	28	28
24 Months COMPLETED	26	27	28	28
24 Months NOT COMPLETED	0	0	0	0

Reasons for withdrawal

Measure	Bariatric Surgery/HIIT High Intensity Interval Training (HIIT) Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months. Procedure/Surgery: Bariatric surgery Patients will undergo bariatric surgery as part of their routine care.	No Bariatric Surgery/HIIT High Intensity Interval Training (HIIT) Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months. Procedure/Surgery: None	Bariatric Surgery/Routine Exercise Routine Exercise Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation). Procedure/Surgery: Bariatric surgery Patients will undergo bariatric surgery as part of their routine care.	No Bariatric Surgery/Routine Exercise Routine Exercise Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation). Procedure/Surgery: None
Baseline Lost to Follow-up	0	2	1	1
Baseline Withdrawal by Subject	0	1	0	1
Baseline Driving Distance/Travel	0	0	2	0
Baseline Family Obligations	0	0	0	1
3 Months Lost to Follow-up	4	1	0	2
3 Months Withdrawal by Subject	1	3	0	0
3 Months Driving Distance/Travel	1	0	0	0
3 Months Family Obligations	0	0	0	1
12 Months Lost to Follow-up	3	1	3	0
12 Months Withdrawal by Subject	0	0	0	1
12 Months Driving Distance/Travel	0	0	1	0

Baseline Characteristics

Effect of Exercise and Surgical Weight Loss on Polyneuropathy

Baseline characteristics by cohort

Measure	No Bariatric Surgery/HIIT n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week.	Bariatric Surgery/Routine Exercise n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months.	Bariatric Surgery/HIIT n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week.	No Bariatric Surgery/Routine Exercise n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months.	Total n=140 Participants Total of all reporting groups
Age, Continuous	50.54 years STANDARD_DEVIATION 7.56 • n=5 Participants	49.66 years STANDARD_DEVIATION 6.98 • n=7 Participants	49.91 years STANDARD_DEVIATION 5.77 • n=5 Participants	51.14 years STANDARD_DEVIATION 8.08 • n=4 Participants	50.31 years STANDARD_DEVIATION 7.1 • n=21 Participants
Sex: Female, Male Female	29 Participants n=5 Participants	26 Participants n=7 Participants	28 Participants n=5 Participants	25 Participants n=4 Participants	108 Participants n=21 Participants
Sex: Female, Male Male	6 Participants n=5 Participants	9 Participants n=7 Participants	7 Participants n=5 Participants	10 Participants n=4 Participants	32 Participants n=21 Participants
Ethnicity (NIH/OMB) Hispanic or Latino	2 Participants n=5 Participants	0 Participants n=7 Participants	0 Participants n=5 Participants	1 Participants n=4 Participants	3 Participants n=21 Participants
Ethnicity (NIH/OMB) Not Hispanic or Latino	33 Participants n=5 Participants	35 Participants n=7 Participants	35 Participants n=5 Participants	34 Participants n=4 Participants	137 Participants n=21 Participants
Ethnicity (NIH/OMB) Unknown or Not Reported	0 Participants n=5 Participants	0 Participants n=7 Participants	0 Participants n=5 Participants	0 Participants n=4 Participants	0 Participants n=21 Participants
Race/Ethnicity, Customized Asian	0 Participants n=5 Participants	0 Participants n=7 Participants	0 Participants n=5 Participants	1 Participants n=4 Participants	1 Participants n=21 Participants
Race/Ethnicity, Customized Bi/Multi Racial Non-Hispanic	0 Participants n=5 Participants	0 Participants n=7 Participants	1 Participants n=5 Participants	0 Participants n=4 Participants	1 Participants n=21 Participants
Race/Ethnicity, Customized Black	13 Participants n=5 Participants	2 Participants n=7 Participants	5 Participants n=5 Participants	14 Participants n=4 Participants	34 Participants n=21 Participants
Race/Ethnicity, Customized Hispanic	1 Participants n=5 Participants	0 Participants n=7 Participants	0 Participants n=5 Participants	1 Participants n=4 Participants	2 Participants n=21 Participants
Race/Ethnicity, Customized Hispanic White	1 Participants n=5 Participants	0 Participants n=7 Participants	0 Participants n=5 Participants	0 Participants n=4 Participants	1 Participants n=21 Participants
Race/Ethnicity, Customized Middle Eastern	0 Participants n=5 Participants	0 Participants n=7 Participants	0 Participants n=5 Participants	1 Participants n=4 Participants	1 Participants n=21 Participants
Race/Ethnicity, Customized Native-American	0 Participants n=5 Participants	0 Participants n=7 Participants	0 Participants n=5 Participants	1 Participants n=4 Participants	1 Participants n=21 Participants
Race/Ethnicity, Customized Native-American/Black	1 Participants n=5 Participants	1 Participants n=7 Participants	0 Participants n=5 Participants	0 Participants n=4 Participants	2 Participants n=21 Participants
Race/Ethnicity, Customized Non-Hispanic White	19 Participants n=5 Participants	32 Participants n=7 Participants	29 Participants n=5 Participants	17 Participants n=4 Participants	97 Participants n=21 Participants

PRIMARY outcome

Timeframe: Baseline, 3 months, 12 months and 24 months

Population: The number analyzed the number of participants that completed the outcome at each respective visit. This number will not include participants dropped out, missed a visit, or declined the particular outcome measure.

Intraepidermal Nerve Fiber Density (IENFD) as assessed by 3mm skin biopsies at the proximal thigh.

Outcome measures

Measure	Bariatric Surgery/HIIT n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months. Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	Bariatric Surgery/Routine Exercise n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation). Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	No Bariatric Surgery/HIIT n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months.	No Bariatric Surgery/Routine Exercise n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation).
Intraepidermal Nerve Fiber Density (IENFD) at the Proximal Thigh Baseline	11.9 fibers/mm Standard Deviation 3.9	12.7 fibers/mm Standard Deviation 4.4	9.8 fibers/mm Standard Deviation 4.9	11 fibers/mm Standard Deviation 4.6
Intraepidermal Nerve Fiber Density (IENFD) at the Proximal Thigh 3 Months	12.6 fibers/mm Standard Deviation 3.9	14.3 fibers/mm Standard Deviation 5	9.9 fibers/mm Standard Deviation 4.2	10.6 fibers/mm Standard Deviation 6
Intraepidermal Nerve Fiber Density (IENFD) at the Proximal Thigh 12 Months	11.5 fibers/mm Standard Deviation 6.1	14.2 fibers/mm Standard Deviation 6.2	9.2 fibers/mm Standard Deviation 4.2	8.5 fibers/mm Standard Deviation 4.4
Intraepidermal Nerve Fiber Density (IENFD) at the Proximal Thigh 24 Months	11.9 fibers/mm Standard Deviation 6.0	13.5 fibers/mm Standard Deviation 6.2	10.3 fibers/mm Standard Deviation 4.3	9.3 fibers/mm Standard Deviation 3.8

SECONDARY outcome

Timeframe: Baseline, 3 months, 12 months and 24 months

Population: The number analyzed the number of participants that completed the outcome at each respective visit. This number will not include participants dropped out, missed a visit, or declined the particular outcome measure.

Intraepidermal Nerve Fiber Density (IENFD) as assessed by 3mm skin biopsies at the distal leg.

Outcome measures

Measure	Bariatric Surgery/HIIT n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months. Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	Bariatric Surgery/Routine Exercise n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation). Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	No Bariatric Surgery/HIIT n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months.	No Bariatric Surgery/Routine Exercise n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation).
Intraepidermal Nerve Fiber Density (IENFD) at Distal Leg. 3 Months	7.3 fibers/mm Standard Deviation 4.1	6.2 fibers/mm Standard Deviation 4.1	6.3 fibers/mm Standard Deviation 3.6	5.5 fibers/mm Standard Deviation 3.8
Intraepidermal Nerve Fiber Density (IENFD) at Distal Leg. 24 Months	6.9 fibers/mm Standard Deviation 4.5	7.4 fibers/mm Standard Deviation 4.4	6.4 fibers/mm Standard Deviation 3.8	5.8 fibers/mm Standard Deviation 4.1
Intraepidermal Nerve Fiber Density (IENFD) at Distal Leg. Baseline	6.3 fibers/mm Standard Deviation 4	6.8 fibers/mm Standard Deviation 4.3	7.3 fibers/mm Standard Deviation 4.1	5.7 fibers/mm Standard Deviation 3.8
Intraepidermal Nerve Fiber Density (IENFD) at Distal Leg. 12 Months	7.7 fibers/mm Standard Deviation 5.2	8.7 fibers/mm Standard Deviation 5.4	6.4 fibers/mm Standard Deviation 3.6	6.4 fibers/mm Standard Deviation 5.5

SECONDARY outcome

Timeframe: Baseline, 3 month, 12 months and 24 months

Population: The number analyzed the number of participants that completed the outcome at each respective visit. This number will not include participants dropped out, missed a visit, or declined the particular outcome measure.

Non-invasive imaging technique of the corneal nerves to quantify nerve density and morphology.

Corneal Nerve Fiber Density are quantified by fibers/mm2, a higher number represents a higher density of fibers. Lower numbers indicate worse neuropathy.

Outcome measures

Measure	Bariatric Surgery/HIIT n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months. Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	Bariatric Surgery/Routine Exercise n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation). Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	No Bariatric Surgery/HIIT n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months.	No Bariatric Surgery/Routine Exercise n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation).
Corneal Confocal Microscopy (CCM) - Fiber Density Baseline-Corneal Nerve Fiber Density (fibers/mm2)	22.1 fibers/mm^2 Standard Deviation 6.8	19.5 fibers/mm^2 Standard Deviation 5.7	19.5 fibers/mm^2 Standard Deviation 6.2	22.4 fibers/mm^2 Standard Deviation 5.4
Corneal Confocal Microscopy (CCM) - Fiber Density 3 Months-Corneal Nerve Fiber Density (fibers/mm2)	20 fibers/mm^2 Standard Deviation 6.5	19.9 fibers/mm^2 Standard Deviation 4.9	19.3 fibers/mm^2 Standard Deviation 6.5	19.8 fibers/mm^2 Standard Deviation 6.3
Corneal Confocal Microscopy (CCM) - Fiber Density 12 Months-Corneal Nerve Fiber Density (fibers/mm2)	19.8 fibers/mm^2 Standard Deviation 9.4	20.7 fibers/mm^2 Standard Deviation 5.2	17.2 fibers/mm^2 Standard Deviation 6.3	18.8 fibers/mm^2 Standard Deviation 6.8
Corneal Confocal Microscopy (CCM) - Fiber Density 24 Months-Corneal Nerve Fiber Density (fibers/mm2)	20.5 fibers/mm^2 Standard Deviation 5.1	20.2 fibers/mm^2 Standard Deviation 3.9	19 fibers/mm^2 Standard Deviation 5.5	18.8 fibers/mm^2 Standard Deviation 5.7

SECONDARY outcome

Timeframe: Baseline, 3 month, 12 months and 24 months

Population: The number analyzed the number of participants that completed the outcome at each respective visit. This number will not include participants dropped out, missed a visit, or declined the particular outcome measure.

Non-invasive imaging technique of the corneal nerves to quantify nerve density and morphology.

Corneal Nerve Branch Density are quantified by branches/mm2, a higher number represents a higher density of branches. Lower numbers indicate worse neuropathy.

Outcome measures

Measure	Bariatric Surgery/HIIT n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months. Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	Bariatric Surgery/Routine Exercise n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation). Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	No Bariatric Surgery/HIIT n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months.	No Bariatric Surgery/Routine Exercise n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation).
Corneal Confocal Microscopy (CCM) - Branch Density Baseline-Corneal Nerve Branch Density (branches/mm2)	56.4 branches/mm^2 Standard Deviation 30.7	57.1 branches/mm^2 Standard Deviation 24.6	53.6 branches/mm^2 Standard Deviation 31.9	54.7 branches/mm^2 Standard Deviation 25.3
Corneal Confocal Microscopy (CCM) - Branch Density 3 Months-Corneal Nerve Branch Density (branches/mm2)	62.2 branches/mm^2 Standard Deviation 32	72.6 branches/mm^2 Standard Deviation 34	62 branches/mm^2 Standard Deviation 31.3	63.9 branches/mm^2 Standard Deviation 37.2
Corneal Confocal Microscopy (CCM) - Branch Density 24 Months-Corneal Nerve Branch Density (branches/mm2)	124.7 branches/mm^2 Standard Deviation 54.3	129.8 branches/mm^2 Standard Deviation 39.7	116.6 branches/mm^2 Standard Deviation 49.1	127.1 branches/mm^2 Standard Deviation 55.9
Corneal Confocal Microscopy (CCM) - Branch Density 12 Months-Corneal Nerve Branch Density (branches/mm2)	126.6 branches/mm^2 Standard Deviation 68.6	137.4 branches/mm^2 Standard Deviation 55.	101.2 branches/mm^2 Standard Deviation 57.9	116.8 branches/mm^2 Standard Deviation 79

SECONDARY outcome

Timeframe: Baseline, 3 month, 12 months and 24 months

Population: The number analyzed the number of participants that completed the outcome at each respective visit. This number will not include participants dropped out, missed a visit, or declined the particular outcome measure.

Non-invasive imaging technique of the corneal nerves to quantify nerve density and morphology.

Corneal Nerve Fiber Length are quantified by mm/mm2, a higher number represents a higher total length of fibers. Lower numbers indicate worse neuropathy .

Outcome measures

Measure	Bariatric Surgery/HIIT n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months. Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	Bariatric Surgery/Routine Exercise n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation). Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	No Bariatric Surgery/HIIT n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months.	No Bariatric Surgery/Routine Exercise n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation).
Corneal Confocal Microscopy (CCM) - Fiber Length 24 Months-Corneal Nerve Fiber Length (mm/mm2)	25.2 mm/mm2 Standard Deviation 6.8	25.3 mm/mm2 Standard Deviation 4.8	24 mm/mm2 Standard Deviation 6.9	25.2 mm/mm2 Standard Deviation 7.4
Corneal Confocal Microscopy (CCM) - Fiber Length Baseline-Corneal Nerve Fiber Length (mm/mm2)	18.6 mm/mm2 Standard Deviation 6.1	18.9 mm/mm2 Standard Deviation 5.3	17.9 mm/mm2 Standard Deviation 6.1	19.3 mm/mm2 Standard Deviation 4.9
Corneal Confocal Microscopy (CCM) - Fiber Length 3 Months-Corneal Nerve Fiber Length (mm/mm2)	19 mm/mm2 Standard Deviation 5.9	20.6 mm/mm2 Standard Deviation 5.3	19.3 mm/mm2 Standard Deviation 5.5	19.3 mm/mm2 Standard Deviation 6.1
Corneal Confocal Microscopy (CCM) - Fiber Length 12 Months-Corneal Nerve Fiber Length (mm/mm2)	25.7 mm/mm2 Standard Deviation 7.5	28 mm/mm2 Standard Deviation 6.7	23 mm/mm2 Standard Deviation 8.1	24.7 mm/mm2 Standard Deviation 8.7

SECONDARY outcome

Timeframe: Baseline, 3 month, 12 months and 24 months

Population: The number analyzed the number of participants that completed the outcome at each respective visit. This number will not include participants dropped out, missed a visit, or declined the particular outcome measure.

Non-invasive imaging technique of the corneal nerves to quantify nerve density and morphology.

Tortuosity Coefficient represents the total tortuosity (twisting/bending of nerves). As a coefficient the value is unitless, a higher value represents greater tortuosity. Lower numbers indicate worse neuropathy.

Outcome measures

Measure	Bariatric Surgery/HIIT n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months. Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	Bariatric Surgery/Routine Exercise n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation). Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	No Bariatric Surgery/HIIT n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months.	No Bariatric Surgery/Routine Exercise n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation).
Corneal Confocal Microscopy (CCM) - Tortuosity Coefficient Baseline-Corneal Tortuosity (coefficient value)	19.4 Coefficient Standard Deviation 5.6	19 Coefficient Standard Deviation 6.3	18.6 Coefficient Standard Deviation 6.7	19.2 Coefficient Standard Deviation 4.9
Corneal Confocal Microscopy (CCM) - Tortuosity Coefficient 3 Months-Corneal Tortuosity (coefficient value)	17.8 Coefficient Standard Deviation 4.3	19.9 Coefficient Standard Deviation 5.6	17.7 Coefficient Standard Deviation 4.6	18.5 Coefficient Standard Deviation 4.9
Corneal Confocal Microscopy (CCM) - Tortuosity Coefficient 12 Months-Corneal Tortuosity (coefficient value)	20.8 Coefficient Standard Deviation 7.2	20.6 Coefficient Standard Deviation 5.6	20.1 Coefficient Standard Deviation 7.3	21.4 Coefficient Standard Deviation 5.8
Corneal Confocal Microscopy (CCM) - Tortuosity Coefficient 24 Months-Corneal Tortuosity (coefficient value)	20 Coefficient Standard Deviation 10.1	22 Coefficient Standard Deviation 7.8	21 Coefficient Standard Deviation 4.9	20.1 Coefficient Standard Deviation 5.6

SECONDARY outcome

Timeframe: Baseline, 3 month, 12 months and 24 months

Population: The number analyzed the number of participants that completed the outcome at each respective visit. This number will not include participants dropped out, missed a visit, or declined the particular outcome measure.

24-2 FDT was used to evaluate retinopathy using visual field deficits. Mean Deviation is presented below.

Mean deviation is the average difference from normal expected value in the patients' particular age group. Lower values indicate more visual deficit. Higher values indicate fewer visual deficit.

Outcome measures

Measure	Bariatric Surgery/HIIT n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months. Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	Bariatric Surgery/Routine Exercise n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation). Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	No Bariatric Surgery/HIIT n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months.	No Bariatric Surgery/Routine Exercise n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation).
24-2 Frequency Doubling Technology (FDT) - Mean Deviation Baseline-Mean Deviation	-1.6 dB Standard Deviation 4.2	-1.6 dB Standard Deviation 2.7	-2 dB Standard Deviation 4.1	-2.5 dB Standard Deviation 4
24-2 Frequency Doubling Technology (FDT) - Mean Deviation 3 Months-Mean Deviation	-1 dB Standard Deviation 4.1	-1.5 dB Standard Deviation 2.7	-1.7 dB Standard Deviation 4	-2.8 dB Standard Deviation 4.6
24-2 Frequency Doubling Technology (FDT) - Mean Deviation 12 Months-Mean Deviation	-0.9 dB Standard Deviation 3.2	-1.3 dB Standard Deviation 3.1	-2.4 dB Standard Deviation 3.8	-1.5 dB Standard Deviation 4.3
24-2 Frequency Doubling Technology (FDT) - Mean Deviation 24 Months-Mean Deviation	-1.1 dB Standard Deviation 3.8	-0.7 dB Standard Deviation 2.7	-2.3 dB Standard Deviation 3.4	-2.1 dB Standard Deviation 4.8

SECONDARY outcome

Timeframe: Baseline, 3 month, 12 months and 24 months

Population: The number analyzed the number of participants that completed the outcome at each respective visit. This number will not include participants dropped out, missed a visit, or declined the particular outcome measure.

24-2 FDT was used to evaluate retinopathy using visual field deficits. Foveal sensitivity is presented below.

Foveal sensitivity is the measurement of the fovea's light detection ability. Lower values suggest visual field deficits.

Outcome measures

Measure	Bariatric Surgery/HIIT n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months. Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	Bariatric Surgery/Routine Exercise n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation). Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	No Bariatric Surgery/HIIT n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months.	No Bariatric Surgery/Routine Exercise n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation).
24-2 Frequency Doubling Technology (FDT) - Foveal Sensitivity dB Baseline-Foveal Sensitivity	27.7 dB Standard Deviation 4.5	28.3 dB Standard Deviation 3.5	26.9 dB Standard Deviation 4.9	25.4 dB Standard Deviation 5.9
24-2 Frequency Doubling Technology (FDT) - Foveal Sensitivity dB 3 Months--Foveal Sensitivity	28.3 dB Standard Deviation 5.3	28.3 dB Standard Deviation 4.5	27.1 dB Standard Deviation 4.1	26.4 dB Standard Deviation 4.6
24-2 Frequency Doubling Technology (FDT) - Foveal Sensitivity dB 12 Months--Foveal Sensitivity	28.1 dB Standard Deviation 4	28.9 dB Standard Deviation 3.6	25.9 dB Standard Deviation 5.5	28.3 dB Standard Deviation 4.6
24-2 Frequency Doubling Technology (FDT) - Foveal Sensitivity dB 24 Months--Foveal Sensitivity	27 dB Standard Deviation 5.3	28.2 dB Standard Deviation 4.5	26.7 dB Standard Deviation 5	26.5 dB Standard Deviation 6.6

SECONDARY outcome

Timeframe: Baseline, 3 month, 12 months and 24 months

Population: The number analyzed the number of participants that completed the outcome at each respective visit. This number will not include participants dropped out, missed a visit, or declined the particular outcome measure.

24-2 FDT was used to evaluate retinopathy using visual field deficits. Pattern SD (PSD) is presented below.

PSD provides information about localized loss. A higher PSD indicates a non-uniform sensitivity loss and visual field deficit.

Outcome measures

Measure	Bariatric Surgery/HIIT n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months. Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	Bariatric Surgery/Routine Exercise n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation). Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	No Bariatric Surgery/HIIT n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months.	No Bariatric Surgery/Routine Exercise n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation).
24-2 Frequency Doubling Technology (FDT) - Pattern SD Baseline-Patter SD	3.4 dB Standard Deviation 1.1	3.1 dB Standard Deviation 1.1	3.3 dB Standard Deviation 1.1	3.7 dB Standard Deviation 1.3
24-2 Frequency Doubling Technology (FDT) - Pattern SD 3 Months-Patter SD	3.1 dB Standard Deviation 1.1	3.2 dB Standard Deviation 1.3	3.3 dB Standard Deviation 1	3.9 dB Standard Deviation 1.7
24-2 Frequency Doubling Technology (FDT) - Pattern SD 12 Months-Patter SD	3.2 dB Standard Deviation 1.1	3.3 dB Standard Deviation 1.7	3.5 dB Standard Deviation 1.1	3.6 dB Standard Deviation 1.6
24-2 Frequency Doubling Technology (FDT) - Pattern SD 24 Months-Patter SD	3.2 dB Standard Deviation 0.8	3.1 dB Standard Deviation 0.7	3.5 dB Standard Deviation 1.1	3.9 dB Standard Deviation 1.7

SECONDARY outcome

Timeframe: Baseline, 3 month, 12 months and 24 months

Population: The number analyzed the number of participants that completed the outcome at each respective visit. This number will not include participants dropped out, missed a visit, or declined the particular outcome measure.

As assessed by fundus photographs, participants were identified as either having retinopathy or not having retinopathy. Data is shown as number of people with retinopathy at a particular study visit.

Outcome measures

Measure	Bariatric Surgery/HIIT n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months. Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	Bariatric Surgery/Routine Exercise n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation). Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	No Bariatric Surgery/HIIT n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months.	No Bariatric Surgery/Routine Exercise n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation).
Retinal Fundus Photography Baseline	0 Participants	1 Participants	1 Participants	1 Participants
Retinal Fundus Photography 3 Months	0 Participants	0 Participants	0 Participants	0 Participants
Retinal Fundus Photography 12 Months	0 Participants	0 Participants	0 Participants	0 Participants
Retinal Fundus Photography 24 Months	0 Participants	0 Participants	0 Participants	0 Participants

SECONDARY outcome

Timeframe: Baseline and 24 months

Population: The number analyzed the number of participants that completed the outcome at each respective visit. This number will not include participants dropped out, missed a visit, or declined the particular outcome measure.

Latency measures the time in millisecond between stimulation and the recording electrode. Was performed on sural, peroneal, and tibial nerves. No response and abnormal values indicate neuropathy.

• Peroneal: 0 - No response, >6.5 - Abnormal
• Sural: 0 - No response, >4.5 - Abnormal
• Tibial: 0 - No response, >6.1 - Abnormal

Outcome measures

Measure	Bariatric Surgery/HIIT n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months. Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	Bariatric Surgery/Routine Exercise n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation). Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	No Bariatric Surgery/HIIT n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months.	No Bariatric Surgery/Routine Exercise n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation).
Nerve Conduction Study (NCS) - Latency Baseline-Peroneal distal motor latency (ms)	4.6 ms Standard Deviation 0.8	4.4 ms Standard Deviation 0.6	4.4 ms Standard Deviation 0.7	4.5 ms Standard Deviation 1
Nerve Conduction Study (NCS) - Latency Baseline-Sural peak latency (ms)	3.8 ms Standard Deviation 0.5	3.7 ms Standard Deviation 0.4	3.6 ms Standard Deviation 0.3	3.9 ms Standard Deviation 0.4
Nerve Conduction Study (NCS) - Latency Baseline-Tibial distal motor latency (ms)	4.8 ms Standard Deviation 0.6	4.9 ms Standard Deviation 0.8	4.5 ms Standard Deviation 0.6	4.7 ms Standard Deviation 0.7
Nerve Conduction Study (NCS) - Latency 24 Months-Peroneal distal motor latency (ms)	4.3 ms Standard Deviation 0.5	4.4 ms Standard Deviation 0.7	4.2 ms Standard Deviation 0.7	4.2 ms Standard Deviation 0.7
Nerve Conduction Study (NCS) - Latency 24 Months-Sural peak latency (ms)	3.5 ms Standard Deviation 0.4	3.5 ms Standard Deviation 0.4	3.6 ms Standard Deviation 0.6	3.4 ms Standard Deviation 0.5
Nerve Conduction Study (NCS) - Latency 24 Months-Tibial distal motor latency (ms)	4.3 ms Standard Deviation 0.7	4.4 ms Standard Deviation 0.8	4.3 ms Standard Deviation 0.9	4.6 ms Standard Deviation 1.1

SECONDARY outcome

Timeframe: Baseline and 24 months

Population: The number analyzed the number of participants that completed the outcome at each respective visit. This number will not include participants dropped out, missed a visit, or declined the particular outcome measure.

Amplitude measures the height of electrical signal (waveform) in millivolts produced by the stimulated motor nerve. Was performed on peroneal, and tibial nerves. No response and abnormal values indicate neuropathy.

• Peroneal: 0 - No response, < 1.1 - Abnormal
• Tibial: 0 - No response, <1.1 - Abnormal

Outcome measures

Measure	Bariatric Surgery/HIIT n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months. Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	Bariatric Surgery/Routine Exercise n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation). Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	No Bariatric Surgery/HIIT n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months.	No Bariatric Surgery/Routine Exercise n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation).
Nerve Conduction Study (NCS) - Motor Amplitude Baseline-Peroneal amplitude (mV)	5.21 mV Standard Deviation 2.39	5.95 mV Standard Deviation 3.05	5.18 mV Standard Deviation 2.56	6.25 mV Standard Deviation 4.13
Nerve Conduction Study (NCS) - Motor Amplitude Baseline-Tibial amplitude (mV)	9.4 mV Standard Deviation 3.59	9.16 mV Standard Deviation 4.55	8.06 mV Standard Deviation 4.4	7.59 mV Standard Deviation 4.66
Nerve Conduction Study (NCS) - Motor Amplitude 24 Months-Peroneal amplitude (mV)	4.9 mV Standard Deviation 2.11	6.23 mV Standard Deviation 2.93	4.93 mV Standard Deviation 2.02	5.11 mV Standard Deviation 4.04
Nerve Conduction Study (NCS) - Motor Amplitude 24 Months-Tibial amplitude (mV)	9.65 mV Standard Deviation 4.98	9.28 mV Standard Deviation 4.75	8.54 mV Standard Deviation 4.02	8.04 mV Standard Deviation 4.22

SECONDARY outcome

Timeframe: Baseline and 24 months

Population: The number analyzed the number of participants that completed the outcome at each respective visit. This number will not include participants dropped out, missed a visit, or declined the particular outcome measure.

Amplitude measures the height of electrical signal (waveform) in microvolts produced by the stimulated sensory nerve. Was performed on sural nerve. No response and abnormal values indicate neuropathy.

• Sural: 0 - No response, <4 - Abnormal

Outcome measures

Measure	Bariatric Surgery/HIIT n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months. Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	Bariatric Surgery/Routine Exercise n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation). Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	No Bariatric Surgery/HIIT n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months.	No Bariatric Surgery/Routine Exercise n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation).
Nerve Conduction Study (NCS) - Sensory Amplitude Baseline-Sural amplitude (µV)	12.4 μV Standard Deviation 5	10.8 μV Standard Deviation 5.3	10.6 μV Standard Deviation 4.7	9.1 μV Standard Deviation 5.3
Nerve Conduction Study (NCS) - Sensory Amplitude 24 Months-Sural amplitude (µV)	12.4 μV Standard Deviation 6.1	14.2 μV Standard Deviation 5.8	10.7 μV Standard Deviation 5.7	10.6 μV Standard Deviation 6.7

SECONDARY outcome

Timeframe: Baseline and 24 months

Population: The number analyzed the number of participants that completed the outcome at each respective visit. This number will not include participants dropped out, missed a visit, or declined the particular outcome measure.

Conduction velocity (V) measures the speed (m/s) at which the electrical impulse travels along the nerve. Was performed on peroneal nerves. No response and abnormal values indicate neuropathy. Abnormal values are <36 or 39, depending on whether certain criteria applied to the participant. Data was not analyzed separately.

Outcome measures

Measure	Bariatric Surgery/HIIT n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months. Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	Bariatric Surgery/Routine Exercise n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation). Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	No Bariatric Surgery/HIIT n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months.	No Bariatric Surgery/Routine Exercise n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation).
Nerve Conduction Study (NCS) - CV Baseline-Peroneal CV (m/s)	46.91 m/s Standard Deviation 4.14	45.37 m/s Standard Deviation 4.27	46.49 m/s Standard Deviation 4.39	45.47 m/s Standard Deviation 6.38
Nerve Conduction Study (NCS) - CV 24 Months-Peroneal CV (m/s)	46.96 m/s Standard Deviation 5.58	47.48 m/s Standard Deviation 4.25	44.69 m/s Standard Deviation 5.43	45.96 m/s Standard Deviation 5.24

SECONDARY outcome

Timeframe: Baseline and 24 months

Population: The number analyzed the number of participants that completed the outcome at each respective visit. This number will not include participants dropped out, missed a visit, or declined the particular outcome measure.

F wave index measures the time in millisecond between stimulation at a distal (near the muscle) point and for the stimulus to travel to the spinal cord and back, allowing to assess the entire length of the nerve.

Was performed on peroneal, and tibial nerves. No response and abnormal values indicate neuropathy.

• Peroneal: 0 - No response, >55 - Abnormal
• Tibial: 0 - No response, >55 - Abnormal

Outcome measures

Measure	Bariatric Surgery/HIIT n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months. Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	Bariatric Surgery/Routine Exercise n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation). Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	No Bariatric Surgery/HIIT n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months.	No Bariatric Surgery/Routine Exercise n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation).
Nerve Conduction Study (NCS) - F Wave Index Baseline-Peroneal F wave index (ms)	48.29 ms Standard Deviation 6.99	49.57 ms Standard Deviation 4.54	49.28 ms Standard Deviation 5.73	48.91 ms Standard Deviation 9.35
Nerve Conduction Study (NCS) - F Wave Index Baseline-Tibial F wave index (ms)	50.84 ms Standard Deviation 8.88	51.92 ms Standard Deviation 5.78	52.45 ms Standard Deviation 5.4	50.8 ms Standard Deviation 9.21
Nerve Conduction Study (NCS) - F Wave Index 24 Months-Peroneal F wave index (ms)	48.45 ms Standard Deviation 4.57	48.5 ms Standard Deviation 5.4	48.95 ms Standard Deviation 5.18	50.07 ms Standard Deviation 6.95
Nerve Conduction Study (NCS) - F Wave Index 24 Months-Tibial F wave index (ms)	50.56 ms Standard Deviation 5.7	50.41 ms Standard Deviation 6.06	50.61 ms Standard Deviation 5.32	51.88 ms Standard Deviation 5.12

SECONDARY outcome

Timeframe: Baseline and 24 months

Population: The number analyzed the number of participants that completed the outcome at each respective visit. This number will not include participants dropped out, missed a visit, or declined the particular outcome measure.

Deep breathing/exhalation to inhalation (E:I) ratio were evaluated using PS monitor software. Values < 1 are abnormal, indicative of cardiovascular autonomic neuropathy

Outcome measures

Measure	Bariatric Surgery/HIIT n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months. Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	Bariatric Surgery/Routine Exercise n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation). Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	No Bariatric Surgery/HIIT n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months.	No Bariatric Surgery/Routine Exercise n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation).
Cardiac Autonomic Neuropathy Testing-Deep Breathing/Exhalation to Inhalation (E:I) Ratio Baseline	1.3 ratio Standard Deviation 0.1	1.2 ratio Standard Deviation 0.2	1.3 ratio Standard Deviation 0.2	1.2 ratio Standard Deviation 0.2
Cardiac Autonomic Neuropathy Testing-Deep Breathing/Exhalation to Inhalation (E:I) Ratio 24 Months	1.2 ratio Standard Deviation 0.2	1.3 ratio Standard Deviation 0.2	1.3 ratio Standard Deviation 0.2	1.2 ratio Standard Deviation 0.2

SECONDARY outcome

Timeframe: Baseline and 24 months

Population: The number analyzed the number of participants that completed the outcome at each respective visit. This number will not include participants dropped out, missed a visit, or declined the particular outcome measure.

Postural change-30:15 ratio was evaluated using PS monitor software. Values < 1 are abnormal, indicative of cardiovascular autonomic neuropathy

Outcome measures

Measure	Bariatric Surgery/HIIT n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months. Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	Bariatric Surgery/Routine Exercise n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation). Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	No Bariatric Surgery/HIIT n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months.	No Bariatric Surgery/Routine Exercise n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation).
Cardiac Autonomic Neuropathy Testing (30:15 Ratio) Baseline	1.1 ratio Standard Deviation 0.2	1.1 ratio Standard Deviation 0	1.1 ratio Standard Deviation 0.1	1.1 ratio Standard Deviation 0.1
Cardiac Autonomic Neuropathy Testing (30:15 Ratio) 24 Months	1.2 ratio Standard Deviation 0.2	1.2 ratio Standard Deviation 0.2	1.2 ratio Standard Deviation 0.2	1.3 ratio Standard Deviation 0.2

SECONDARY outcome

Timeframe: Baseline and 24 months

Population: The number analyzed the number of participants that completed the outcome at each respective visit. This number will not include participants dropped out, missed a visit, or declined the particular outcome measure.

Valsalva ratio was evaluated using PS monitor software. Values <= 1.10 are abnormal, indicative of cardiovascular autonomic neuropathy

Outcome measures

Measure	Bariatric Surgery/HIIT n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months. Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	Bariatric Surgery/Routine Exercise n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation). Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	No Bariatric Surgery/HIIT n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months.	No Bariatric Surgery/Routine Exercise n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation).
Cardiac Autonomic Neuropathy Testing (Valsalva Ratio) Baseline	1.5 ratio Standard Deviation 0.2	1.5 ratio Standard Deviation 0.2	1.4 ratio Standard Deviation 0.2	1.4 ratio Standard Deviation 0.2
Cardiac Autonomic Neuropathy Testing (Valsalva Ratio) 24 Months	1.3 ratio Standard Deviation 0.2	1.4 ratio Standard Deviation 0.3	1.3 ratio Standard Deviation 0.2	1.4 ratio Standard Deviation 0.3

SECONDARY outcome

Timeframe: 24 months

Population: The number analyzed the number of participants that completed the outcome at each respective visit. This number will not include participants dropped out, missed a visit, or declined the particular outcome measure.

Toronto definition of probable neuropathy is having at least 2 out of 3 of the following: abnormal sensory examination, reflexes, and patient-reported symptoms. Data is reported as number of participants who, under the Toronto definition, were identified as having probable polyneuropathy.

Outcome measures

Measure	Bariatric Surgery/HIIT n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months. Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	Bariatric Surgery/Routine Exercise n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation). Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	No Bariatric Surgery/HIIT n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months.	No Bariatric Surgery/Routine Exercise n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation).
Participants With Probable Polyneuropathy as Defined by the Toronto Definition of Probable Neuropathy Baseline	6 participants with probable neuropathy	5 participants with probable neuropathy	9 participants with probable neuropathy	11 participants with probable neuropathy
Participants With Probable Polyneuropathy as Defined by the Toronto Definition of Probable Neuropathy 24 Months	9 participants with probable neuropathy	7 participants with probable neuropathy	7 participants with probable neuropathy	9 participants with probable neuropathy

SECONDARY outcome

Timeframe: Baseline, 3 month, 12 months and 24 months

Population: The number analyzed the number of participants that completed the outcome at each respective visit. This number will not include participants dropped out, missed a visit, or declined the particular outcome measure.

MNSI questionnaire is scored from 0-15, score > 4 indicate neuropathy, higher scores indicate worse neuropathy.

A score of 1 point is given for answers of "yes" for questions 1-6, 8-12, 14, and 15 and "no" for questions 7 and 13.

Outcome measures

Measure	Bariatric Surgery/HIIT n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months. Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	Bariatric Surgery/Routine Exercise n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation). Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	No Bariatric Surgery/HIIT n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months.	No Bariatric Surgery/Routine Exercise n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation).
Michigan Neuropathy Screening Instrument (MNSI) Baseline Questionnaire	2.5 score on a scale Standard Deviation 2.4	2.5 score on a scale Standard Deviation 1.7	2.4 score on a scale Standard Deviation 2.2	2.8 score on a scale Standard Deviation 2.1
Michigan Neuropathy Screening Instrument (MNSI) 3 Months Questionnaire	2.5 score on a scale Standard Deviation 2.7	2 score on a scale Standard Deviation 1.9	2.5 score on a scale Standard Deviation 2.7	2.3 score on a scale Standard Deviation 2.2
Michigan Neuropathy Screening Instrument (MNSI) 12 Months Questionnaire	2.7 score on a scale Standard Deviation 2.9	2.1 score on a scale Standard Deviation 2.2	2.3 score on a scale Standard Deviation 2	2.8 score on a scale Standard Deviation 2.1
Michigan Neuropathy Screening Instrument (MNSI) 24 Months Questionnaire	3.2 score on a scale Standard Deviation 2.6	2.3 score on a scale Standard Deviation 2	1.8 score on a scale Standard Deviation 1.7	2.8 score on a scale Standard Deviation 2

SECONDARY outcome

Timeframe: Baseline, 3 month, 12 months and 24 months

Population: The number analyzed the number of participants that completed the outcome at each respective visit. This number will not include participants dropped out, missed a visit, or declined the particular outcome measure.

MNSI exam is scored from 0-8, score >= 2.5 indicate neuropathy. Higher scores indicate worse neuropathy.

Outcome measures

Measure	Bariatric Surgery/HIIT n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months. Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	Bariatric Surgery/Routine Exercise n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation). Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	No Bariatric Surgery/HIIT n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months.	No Bariatric Surgery/Routine Exercise n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation).
Michigan Neuropathy Screening Instrument (MNSI) - Exam Baseline Exam	1 score on a scale Standard Deviation 1.4	0.9 score on a scale Standard Deviation 1.2	1.1 score on a scale Standard Deviation 1.4	1.3 score on a scale Standard Deviation 1.7
Michigan Neuropathy Screening Instrument (MNSI) - Exam 3 Months Exam	1 score on a scale Standard Deviation 1.4	0.4 score on a scale Standard Deviation 0.7	1.2 score on a scale Standard Deviation 1.8	1.5 score on a scale Standard Deviation 1.6
Michigan Neuropathy Screening Instrument (MNSI) - Exam 12 Months Exam	1.1 score on a scale Standard Deviation 1.3	1 score on a scale Standard Deviation 1.3	1.1 score on a scale Standard Deviation 1.7	1.4 score on a scale Standard Deviation 1.7
Michigan Neuropathy Screening Instrument (MNSI) - Exam 24 Months Exam	0.9 score on a scale Standard Deviation 1.3	0.6 score on a scale Standard Deviation 0.9	1.3 score on a scale Standard Deviation 1.8	1.8 score on a scale Standard Deviation 1.5

SECONDARY outcome

Timeframe: Baseline, 3 month, 12 months and 24 months

Population: The number analyzed the number of participants that completed the outcome at each respective visit. This number will not include participants dropped out, missed a visit, or declined the particular outcome measure.

The Michigan Neuropathy Screening Instrument (MNSI) index is a weighted composite score computed using the sum of the b-coefficients for all items within the MNSI questionnaire (15 questions) and MNSI exam (4 physical/visual exam).

Range: -0.93, 7.39 Values > 2.5407 are indicative of clinical neuropathy

Outcome measures

Measure	Bariatric Surgery/HIIT n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months. Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	Bariatric Surgery/Routine Exercise n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation). Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	No Bariatric Surgery/HIIT n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months.	No Bariatric Surgery/Routine Exercise n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation).
Michigan Neuropathy Screening Instrument (MNSI) - Index 24 Months Index	1.7 MNSI Score Standard Deviation 1.5	1.5 MNSI Score Standard Deviation 1.5	1.9 MNSI Score Standard Deviation 1.3	1.9 MNSI Score Standard Deviation 1.2
Michigan Neuropathy Screening Instrument (MNSI) - Index Baseline Index	1.6 MNSI Score Standard Deviation 1.3	1.5 MNSI Score Standard Deviation 0.9	1.4 MNSI Score Standard Deviation 1.3	1.8 MNSI Score Standard Deviation 1.3
Michigan Neuropathy Screening Instrument (MNSI) - Index 3 Months Index	1.6 MNSI Score Standard Deviation 1.3	1.1 MNSI Score Standard Deviation 1	1.7 MNSI Score Standard Deviation 1.4	1.8 MNSI Score Standard Deviation 1.5
Michigan Neuropathy Screening Instrument (MNSI) - Index 12 Months Index	1.7 MNSI Score Standard Deviation 1.6	1.3 MNSI Score Standard Deviation 1.1	1.6 MNSI Score Standard Deviation 1.3	2 MNSI Score Standard Deviation 1.5

SECONDARY outcome

Timeframe: Baseline, 3 month, 12 months and 24 months

Population: The number analyzed the number of participants that completed the outcome at each respective visit. This number will not include participants dropped out, missed a visit, or declined the particular outcome measure.

UENS is a composite score with five sections measuring multiple clinical measures of nerve injury. Sections are scored separately for each side (Right vs Left), and the total score is the sum across everything. Range: 0-42, higher score represents more severe polyneuropathy.

Outcome measures

Measure	Bariatric Surgery/HIIT n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months. Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	Bariatric Surgery/Routine Exercise n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation). Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	No Bariatric Surgery/HIIT n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months.	No Bariatric Surgery/Routine Exercise n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation).
Utah Early Neuropathy Score (UENS) Baseline UENS Total Score	2.4 score on a scale Standard Deviation 4.1	1.6 score on a scale Standard Deviation 2.6	2.4 score on a scale Standard Deviation 3.7	3.5 score on a scale Standard Deviation 4.6
Utah Early Neuropathy Score (UENS) 3 Months UENS Total Score	1.7 score on a scale Standard Deviation 2.8	1.8 score on a scale Standard Deviation 3.5	2.9 score on a scale Standard Deviation 5.2	3 score on a scale Standard Deviation 4.3
Utah Early Neuropathy Score (UENS) 12 Months UENS Total Score	3.9 score on a scale Standard Deviation 4.9	2.8 score on a scale Standard Deviation 3.8	3.2 score on a scale Standard Deviation 5.2	4.8 score on a scale Standard Deviation 6.3
Utah Early Neuropathy Score (UENS) 24 Months UENS Total Score	2.8 score on a scale Standard Deviation 3.7	2.5 score on a scale Standard Deviation 3.6	2.9 score on a scale Standard Deviation 2.3	3.8 score on a scale Standard Deviation 4.8

SECONDARY outcome

Timeframe: Baseline, 3 month, 12 months and 24 months

Population: The number analyzed the number of participants that completed the outcome at each respective visit. This number will not include participants dropped out, missed a visit, or declined the particular outcome measure.

mTNS is a scale of 0-33 that measures neuropathy symptoms and exam findings. Higher scores indicate more severe polyneuropathy.

Outcome measures

Measure	Bariatric Surgery/HIIT n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months. Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	Bariatric Surgery/Routine Exercise n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation). Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	No Bariatric Surgery/HIIT n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months.	No Bariatric Surgery/Routine Exercise n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation).
Modified Toronto Neuropathy Score (mTNS) Baseline	3.8 score on a scale Standard Deviation 7.7	1.5 score on a scale Standard Deviation 2.6	2.1 score on a scale Standard Deviation 3.4	3.5 score on a scale Standard Deviation 5.7
Modified Toronto Neuropathy Score (mTNS) 3 Months	2.1 score on a scale Standard Deviation 4.2	1.3 score on a scale Standard Deviation 1.5	2.1 score on a scale Standard Deviation 4.4	2.8 score on a scale Standard Deviation 4.7
Modified Toronto Neuropathy Score (mTNS) 12 Months	3.5 score on a scale Standard Deviation 5.9	1.8 score on a scale Standard Deviation 3	2.3 score on a scale Standard Deviation 4.1	3.4 score on a scale Standard Deviation 5.9
Modified Toronto Neuropathy Score (mTNS) 24 Months	4.4 score on a scale Standard Deviation 6.4	2.6 score on a scale Standard Deviation 2.9	1.4 score on a scale Standard Deviation 1.9	3.2 score on a scale Standard Deviation 3.9

SECONDARY outcome

Timeframe: Baseline, 3 month, 12 months and 24 months

Population: The number analyzed the number of participants that completed the outcome at each respective visit. This number will not include participants dropped out, missed a visit, or declined the particular outcome measure.

SAS evaluates the presence and magnitude of autonomic symptoms. Total impact score ranges from 0-60 (or up to 55 for participants to whom certain criteria did not apply). Higher score indicates worse autonomic neuropathy

Outcome measures

Measure	Bariatric Surgery/HIIT n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months. Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	Bariatric Surgery/Routine Exercise n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation). Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	No Bariatric Surgery/HIIT n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months.	No Bariatric Surgery/Routine Exercise n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation).
Survey of Autonomic Symptoms (SAS) Baseline	4.7 score on a scale Standard Deviation 4.1	5 score on a scale Standard Deviation 4.3	5.1 score on a scale Standard Deviation 4.7	5.1 score on a scale Standard Deviation 5.1
Survey of Autonomic Symptoms (SAS) 3 Months	8.2 score on a scale Standard Deviation 8.3	4.9 score on a scale Standard Deviation 4.2	3.4 score on a scale Standard Deviation 3.8	4.8 score on a scale Standard Deviation 4.3
Survey of Autonomic Symptoms (SAS) 12 Months	5.3 score on a scale Standard Deviation 7.2	5.1 score on a scale Standard Deviation 4.1	4.5 score on a scale Standard Deviation 3.6	6.2 score on a scale Standard Deviation 7.3
Survey of Autonomic Symptoms (SAS) 24 Months	5.3 score on a scale Standard Deviation 7.1	8.4 score on a scale Standard Deviation 4	5.3 score on a scale Standard Deviation 5.3	6.2 score on a scale Standard Deviation 5.7

SECONDARY outcome

Timeframe: Baseline, 3 month, 12 months and 24 months

Population: The number analyzed the number of participants that completed the outcome at each respective visit. This number will not include participants dropped out, missed a visit, or declined the particular outcome measure.

DNS is a questionnaire of neuropathy symptoms. Score ranges 0-4, >/=1 indicates polyneuropathy. 0 indicates no polyneuropathy.

Outcome measures

Measure	Bariatric Surgery/HIIT n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months. Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	Bariatric Surgery/Routine Exercise n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation). Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	No Bariatric Surgery/HIIT n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months.	No Bariatric Surgery/Routine Exercise n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation).
Diabetic Neuropathy Score (DNS) Baseline	1.1 score on a scale Standard Deviation 1.3	0.9 score on a scale Standard Deviation 0.9	0.8 score on a scale Standard Deviation 1	1.1 score on a scale Standard Deviation 1.4
Diabetic Neuropathy Score (DNS) 3 Months	1.1 score on a scale Standard Deviation 1.4	0.6 score on a scale Standard Deviation 1	0.8 score on a scale Standard Deviation 1.2	0.9 score on a scale Standard Deviation 1.4
Diabetic Neuropathy Score (DNS) 12 Moths	1 score on a scale Standard Deviation 1.3	0.6 score on a scale Standard Deviation 0.9	0.8 score on a scale Standard Deviation 1.2	0.9 score on a scale Standard Deviation 1.1
Diabetic Neuropathy Score (DNS) 24 Months	1.3 score on a scale Standard Deviation 1.5	0.6 score on a scale Standard Deviation 1	0.7 score on a scale Standard Deviation 0.8	1.1 score on a scale Standard Deviation 1.4

SECONDARY outcome

Timeframe: Baseline, 3 months, 12 months, 24 months

Population: The number analyzed the number of participants that completed the outcome at each respective visit. This number will not include participants dropped out, missed a visit, or declined the particular outcome measure.

Sum of the sensory score (0-30) and affective score (0-15) for a total score of 0-45. A higher score represents greater pain present.

Outcome measures

Measure	Bariatric Surgery/HIIT n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months. Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	Bariatric Surgery/Routine Exercise n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation). Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	No Bariatric Surgery/HIIT n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months.	No Bariatric Surgery/Routine Exercise n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation).
Short Form McGill Pain Questionnaire Baseline	3.7 score on a scale Standard Deviation 4.4	3.1 score on a scale Standard Deviation 4.4	2.7 score on a scale Standard Deviation 4.1	3.5 score on a scale Standard Deviation 5.5
Short Form McGill Pain Questionnaire 3 Months	3.8 score on a scale Standard Deviation 7.7	2.1 score on a scale Standard Deviation 3.6	2.6 score on a scale Standard Deviation 4.2	3.5 score on a scale Standard Deviation 6
Short Form McGill Pain Questionnaire 12 Months	3.3 score on a scale Standard Deviation 8.5	2.3 score on a scale Standard Deviation 3.4	2.4 score on a scale Standard Deviation 2.8	2.6 score on a scale Standard Deviation 4.5
Short Form McGill Pain Questionnaire 24 Months	5.2 score on a scale Standard Deviation 6.6	2.5 score on a scale Standard Deviation 4.5	2.1 score on a scale Standard Deviation 2.6	2.2 score on a scale Standard Deviation 3.8

SECONDARY outcome

Timeframe: Baseline, 3 months, 12 months, 24 months

Population: The number analyzed the number of participants that completed the outcome at each respective visit. This number will not include participants dropped out, missed a visit, or declined the particular outcome measure.

Participant reported pain scale with range 0-10, higher score indicates more pain.

Outcome measures

Measure	Bariatric Surgery/HIIT n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months. Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	Bariatric Surgery/Routine Exercise n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation). Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	No Bariatric Surgery/HIIT n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months.	No Bariatric Surgery/Routine Exercise n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation).
Numerical Rating Scale for Pain Baseline	2.2 score on a scale Standard Deviation 2.6	2.7 score on a scale Standard Deviation 3.4	2.5 score on a scale Standard Deviation 3.7	3.8 score on a scale Standard Deviation 4
Numerical Rating Scale for Pain 3 Months	3.3 score on a scale Standard Deviation 4.2	2.7 score on a scale Standard Deviation 3.7	4.2 score on a scale Standard Deviation 4.2	3.6 score on a scale Standard Deviation 4.2
Numerical Rating Scale for Pain 12 Months	2.9 score on a scale Standard Deviation 4.0	3.5 score on a scale Standard Deviation 4.2	6.1 score on a scale Standard Deviation 4.4	3.8 score on a scale Standard Deviation 4.4
Numerical Rating Scale for Pain 24 Months	3.8 score on a scale Standard Deviation 4.0	4.7 score on a scale Standard Deviation 4.7	4.5 score on a scale Standard Deviation 4.3	5 score on a scale Standard Deviation 4.2

SECONDARY outcome

Timeframe: Baseline, 3 months, 12 months, and 24 months

Population: The number analyzed the number of participants that completed the outcome at each respective visit. This number will not include participants dropped out, missed a visit, or declined the particular outcome measure.

Neuropathy Quality of Life (NeuroQOL) evaluates symptoms and function in regard to quality of life over the past four weeks. Range 1-15, higher score indicates neuropathy having a greater impact on quality of life.

Outcome measures

Measure	Bariatric Surgery/HIIT n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months. Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	Bariatric Surgery/Routine Exercise n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation). Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	No Bariatric Surgery/HIIT n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months.	No Bariatric Surgery/Routine Exercise n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation).
Neuropathy Quality of Life (NeuroQOL) Baseline	2.62 NeuroQOL Score Standard Deviation 2.34	2.13 NeuroQOL Score Standard Deviation 1.12	2.1 NeuroQOL Score Standard Deviation 0.94	2.71 NeuroQOL Score Standard Deviation 1.98
Neuropathy Quality of Life (NeuroQOL) 3 Months	2.49 NeuroQOL Score Standard Deviation 2.37	1.62 NeuroQOL Score Standard Deviation 0.5	1.93 NeuroQOL Score Standard Deviation 0.97	2.7 NeuroQOL Score Standard Deviation 1.5
Neuropathy Quality of Life (NeuroQOL) 12 Months	2.23 NeuroQOL Score Standard Deviation 2.48	1.62 NeuroQOL Score Standard Deviation 0.43	2.21 NeuroQOL Score Standard Deviation 0.87	2.42 NeuroQOL Score Standard Deviation 1.26
Neuropathy Quality of Life (NeuroQOL) 24 Months	3.07 NeuroQOL Score Standard Deviation 3.02	1.86 NeuroQOL Score Standard Deviation 0.86	1.7 NeuroQOL Score Standard Deviation 0.58	2.55 NeuroQOL Score Standard Deviation 1.98

SECONDARY outcome

Timeframe: Baseline, 3 months, 12 months, and 24 months

Population: The number analyzed the number of participants that completed the outcome at each respective visit. This number will not include participants dropped out, missed a visit, or declined the particular outcome measure.

This test measures in seconds how long it takes the participant to stand up from a seated position, walk around a cone places 8 feet away, and return to the chair and sit down. Less time indicates better speed, agility, and balance when moving.

Outcome measures

Measure	Bariatric Surgery/HIIT n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months. Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	Bariatric Surgery/Routine Exercise n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation). Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	No Bariatric Surgery/HIIT n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months.	No Bariatric Surgery/Routine Exercise n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation).
8 Foot Get Up and Go Test Baseline	6.2 Seconds Standard Deviation 1.5	6.1 Seconds Standard Deviation 1	6.4 Seconds Standard Deviation 1.2	6.6 Seconds Standard Deviation 1.4
8 Foot Get Up and Go Test 3 Months	6 Seconds Standard Deviation 1.1	5.9 Seconds Standard Deviation 0.8	6.4 Seconds Standard Deviation 1.3	6.8 Seconds Standard Deviation 1.5
8 Foot Get Up and Go Test 12 Months	6.2 Seconds Standard Deviation 1.2	5.6 Seconds Standard Deviation 0.7	6.6 Seconds Standard Deviation 1.6	6.8 Seconds Standard Deviation 1.3
8 Foot Get Up and Go Test 24 Months	7.1 Seconds Standard Deviation 3.9	6 Seconds Standard Deviation 0.9	6.5 Seconds Standard Deviation 1	7 Seconds Standard Deviation 1.2

SECONDARY outcome

Timeframe: Baseline, 3 months, 12 months, and 24 months

Population: The number analyzed the number of participants that completed the outcome at each respective visit. This number will not include participants dropped out, missed a visit, or declined the particular outcome measure.

Berg Balance Scale measures participants' ability to balance and avoid falls. Scores range from 0-56, higher score indicates less likely to fall.

Outcome measures

Measure	Bariatric Surgery/HIIT n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months. Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	Bariatric Surgery/Routine Exercise n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation). Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	No Bariatric Surgery/HIIT n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months.	No Bariatric Surgery/Routine Exercise n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation).
Berg Balance Scale Baseline	55.41 score on a scale Standard Deviation 1.16	55.53 score on a scale Standard Deviation 1.02	55.41 score on a scale Standard Deviation 1.16	54.57 score on a scale Standard Deviation 1.93
Berg Balance Scale 3 Months	55.48 score on a scale Standard Deviation 1.5	55.47 score on a scale Standard Deviation 1.27	55.48 score on a scale Standard Deviation 1.5	54.81 score on a scale Standard Deviation 1.73
Berg Balance Scale 12 Months	54.88 score on a scale Standard Deviation 2.12	55.41 score on a scale Standard Deviation 1.48	54.88 score on a scale Standard Deviation 2.12	54.65 score on a scale Standard Deviation 1.6
Berg Balance Scale 24 Months	55.15 score on a scale Standard Deviation 2.36	55.5 score on a scale Standard Deviation 1.2	55.15 score on a scale Standard Deviation 2.36	55 score on a scale Standard Deviation 1.89

SECONDARY outcome

Timeframe: Baseline, 3 months, 12 months, and 24 months

Population: The number analyzed the number of participants that completed the outcome at each respective visit. This number will not include participants dropped out, missed a visit, or declined the particular outcome measure.

Patient response indicating if they have fallen in the last year. Data is shown as number of people who have fallen in the last year.

Outcome measures

Measure	Bariatric Surgery/HIIT n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months. Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	Bariatric Surgery/Routine Exercise n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation). Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	No Bariatric Surgery/HIIT n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months.	No Bariatric Surgery/Routine Exercise n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation).
Modified Falls Efficacy Scale - Fall Evaluation Baseline	8 Participants	9 Participants	9 Participants	12 Participants
Modified Falls Efficacy Scale - Fall Evaluation 3 Months	8 Participants	8 Participants	8 Participants	5 Participants
Modified Falls Efficacy Scale - Fall Evaluation 24 Months	6 Participants	8 Participants	7 Participants	6 Participants
Modified Falls Efficacy Scale - Fall Evaluation 12 Months	7 Participants	2 Participants	2 Participants	10 Participants

SECONDARY outcome

Timeframe: Baseline, 3 months, 12 months, and 24 months

Population: The number analyzed the number of participants that completed the outcome at each respective visit. This number will not include participants dropped out, missed a visit, or declined the particular outcome measure.

Neurothesiometer is placed on the bottom of the great toe, and slowly increased until participant reports they can feel the vibration. The greater the microns, the less feeling the participant has, suggestive of worse sensory function.

Value > 25 Microns is indicative of neuropathy. There is no known maximum range. Lower values indicate better sensory function.

Outcome measures

Measure	Bariatric Surgery/HIIT n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months. Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	Bariatric Surgery/Routine Exercise n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation). Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	No Bariatric Surgery/HIIT n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months.	No Bariatric Surgery/Routine Exercise n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation).
Neurothesiometer Baseline	8.7 Microns Standard Deviation 8.3	10.2 Microns Standard Deviation 9	21.1 Microns Standard Deviation 47.4	20.2 Microns Standard Deviation 34.9
Neurothesiometer 3 Months	9.7 Microns Standard Deviation 11.3	8 Microns Standard Deviation 5.6	20.8 Microns Standard Deviation 47.7	15.4 Microns Standard Deviation 27
Neurothesiometer 12 Months	12.1 Microns Standard Deviation 12.8	9.9 Microns Standard Deviation 15	19.1 Microns Standard Deviation 47.7	23.3 Microns Standard Deviation 48.3
Neurothesiometer 24 Months	13.6 Microns Standard Deviation 14.2	8 Microns Standard Deviation 6.2	12 Microns Standard Deviation 11.3	21.7 Microns Standard Deviation 39.5

SECONDARY outcome

Timeframe: Baseline and at 24 months

Population: The number analyzed the number of participants that completed the outcome at each respective visit. This number will not include participants dropped out, missed a visit, or declined the particular outcome measure.

NIH Toolbox Cognition Fluid (Range: 0-100) - Composite score derived as an average across five cognitive domains.

It's a fully adjusted T-score comparing the participant to a nationally representative sample, stratified by age and other demographics.

Individual domain scores are fully adjusted T score with range 0-100 and measures the following-

• Inhibitory Control and Attention - executive function, attention .
• Dimensional Change Card Sort - executive function
• Picture Sequence Memory - episodic memory
• List Sorting Working Memory - working memory
• Pattern Comparison - processing speed

A T-score of 50 represents the population mean. A score of 60 indicates that the participant is 1 SD above the national average for individuals with similar demographic characteristics

Higher scores reflect better cognitive functionality. No set clinical threshold, scores above mean indicate above average cognition for a given age group.

Outcome measures

Measure	Bariatric Surgery/HIIT n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months. Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	Bariatric Surgery/Routine Exercise n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation). Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	No Bariatric Surgery/HIIT n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months.	No Bariatric Surgery/Routine Exercise n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation).
NIH Toolbox Cognitive Battery Baseline Inhibitory Control and Attention Test	42.6 T-score Standard Deviation 6.8	44 T-score Standard Deviation 8.3	42.7 T-score Standard Deviation 7.8	43 T-score Standard Deviation 8.9
NIH Toolbox Cognitive Battery Baseline Dimensional Change Card Sort Test	51.6 T-score Standard Deviation 12.9	54.6 T-score Standard Deviation 11.5	54.5 T-score Standard Deviation 13.2	51.8 T-score Standard Deviation 12.3
NIH Toolbox Cognitive Battery Baseline Picture Sequence Memory Test	56.2 T-score Standard Deviation 11.8	55.8 T-score Standard Deviation 12.2	55.6 T-score Standard Deviation 12	54.2 T-score Standard Deviation 8.5
NIH Toolbox Cognitive Battery Baseline List Sorting Working Memory Test	54.8 T-score Standard Deviation 10.1	51.7 T-score Standard Deviation 9.3	53.3 T-score Standard Deviation 10.8	50.3 T-score Standard Deviation 8.2
NIH Toolbox Cognitive Battery Baseline Pattern Comparison Processing Speed Test	48.9 T-score Standard Deviation 13.1	49.4 T-score Standard Deviation 12.2	51 T-score Standard Deviation 15	50.4 T-score Standard Deviation 13.9
NIH Toolbox Cognitive Battery Baseline Cognition Fluid Composite	51.2 T-score Standard Deviation 12.3	51.6 T-score Standard Deviation 11.8	52.1 T-score Standard Deviation 11.2	49.8 T-score Standard Deviation 11.3
NIH Toolbox Cognitive Battery 24 Months Inhibitory Control and Attention Test	42.9 T-score Standard Deviation 9.3	44.3 T-score Standard Deviation 7.6	44.2 T-score Standard Deviation 8.2	43.9 T-score Standard Deviation 8.5
NIH Toolbox Cognitive Battery 24 Months Dimensional Change Card Sort Test	53.7 T-score Standard Deviation 12.5	53.7 T-score Standard Deviation 13.5	56.7 T-score Standard Deviation 11	54.6 T-score Standard Deviation 10.9
NIH Toolbox Cognitive Battery 24 Months Picture Sequence Memory Test	55.9 T-score Standard Deviation 10.8	54.7 T-score Standard Deviation 13	58.7 T-score Standard Deviation 10.8	56.3 T-score Standard Deviation 10.8
NIH Toolbox Cognitive Battery 24 Months List Sorting Working Memory Test	56.6 T-score Standard Deviation 10.1	52.1 T-score Standard Deviation 8.6	54.4 T-score Standard Deviation 7.5	50.7 T-score Standard Deviation 11.4
NIH Toolbox Cognitive Battery 24 Months Pattern Comparison Processing Speed Test	52.7 T-score Standard Deviation 13.8	46.7 T-score Standard Deviation 16.7	48.8 T-score Standard Deviation 13.4	47.3 T-score Standard Deviation 15.7
NIH Toolbox Cognitive Battery 24 Months Cognition Fluid Composite	53.5 T-score Standard Deviation 12.2	50.4 T-score Standard Deviation 11.2	53.9 T-score Standard Deviation 9.1	50.6 T-score Standard Deviation 10.2

SECONDARY outcome

Timeframe: Baseline and at 24 months

Population: The number analyzed the number of participants that completed the outcome at each respective visit. This number will not include participants dropped out, missed a visit, or declined the particular outcome measure.

Used to evaluate verbal learning and memory using a list of 15 unrelated words presented to the participant over repeat trial.

Includes 3 independent scales:

• Auditory Learning (Total recall) - Measures memory and learning ability. Raw score range (0- 75)
• Delayed Recall - Measures long term memory retention. Raw score range (0-15)
• Recognition - Measures ability to recognize previously learned information. Raw score range (0-15).
• Raw scores were converted to age-standardized Z-scores using 10-year age bands (e.g., 20-29, 30-39, 40-49, etc.), with a mean of 0 and standard deviation of 1.
• A Z-score of 0 represents the population mean
• For each scale, scores above 0 are better. Standard deviations above the mean indicates a better learning and memory ability for a given age group.

No set clinical threshold, scores above mean indicate above average cognition for a given age group.

Outcome measures

Measure	Bariatric Surgery/HIIT n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months. Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	Bariatric Surgery/Routine Exercise n=35 Participants Patients who have undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation). Bariatric surgery: Patients will undergo bariatric surgery as part of their routine care	No Bariatric Surgery/HIIT n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a high intensity interval training (HIIT) protocol for 24 months. Patients will complete 2 supervised HIIT sessions and 1 unsupervised HIIT session a week. High Intensity Interval Training (HIIT): Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months.	No Bariatric Surgery/Routine Exercise n=35 Participants Patients who have not undergone bariatric surgery will be randomized to this arm and will follow a standard routine exercise regimen for 24 months. Routine Exercise: Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation).
Rey Auditory Verbal Learning Test Baseline Auditory Learning	0.1 Z-score Standard Deviation 1.2	0.3 Z-score Standard Deviation 1.2	0.4 Z-score Standard Deviation 0.8	0.4 Z-score Standard Deviation 1
Rey Auditory Verbal Learning Test Baseline Delayed Recall	0 Z-score Standard Deviation 1.1	-0.2 Z-score Standard Deviation 1.1	0.1 Z-score Standard Deviation 0.9	-0.1 Z-score Standard Deviation 1
Rey Auditory Verbal Learning Test Baseline Recognition	0.7 Z-score Standard Deviation 0.8	0.6 Z-score Standard Deviation 0.8	0.7 Z-score Standard Deviation 1.2	0.7 Z-score Standard Deviation 0.9
Rey Auditory Verbal Learning Test 24 Months Auditory Learning	-0.2 Z-score Standard Deviation 1.3	0.2 Z-score Standard Deviation 1.2	0.4 Z-score Standard Deviation 1	0 Z-score Standard Deviation 1.1
Rey Auditory Verbal Learning Test 24 Months Delayed Recall	-0.4 Z-score Standard Deviation 1	-0.1 Z-score Standard Deviation 1	0.2 Z-score Standard Deviation 0.9	-0.1 Z-score Standard Deviation 1.1
Rey Auditory Verbal Learning Test 24 Months Recognition	0.6 Z-score Standard Deviation 1.2	0.9 Z-score Standard Deviation 0.8	0.8 Z-score Standard Deviation 1.2	0 Z-score Standard Deviation 1

Adverse Events

Bariatric Surgery/HIIT

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

No Bariatric Surgery/HIIT

Serious events: 0 serious events

Other events: 2 other events

Deaths: 0 deaths

Bariatric Surgery/Routine Exercise

Serious events: 0 serious events

Other events: 1 other events

Deaths: 0 deaths

No Bariatric Surgery/Routine Exercise

Serious events: 0 serious events

Other events: 0 other events

Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Measure	Bariatric Surgery/HIIT n=35 participants at risk High Intensity Interval Training (HIIT) Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months. Procedure/Surgery: Bariatric surgery Patients will undergo bariatric surgery as part of their routine care.	No Bariatric Surgery/HIIT n=35 participants at risk High Intensity Interval Training (HIIT) Patients will complete a HIIT training protocol of a total of 10 x 1 min intervals at 90% heart rate (HR) max. They will continue this training protocol, 3 sessions a week (2 supervised and 1 unsupervised), for 24 months. Procedure/Surgery: None	Bariatric Surgery/Routine Exercise n=35 participants at risk Routine Exercise Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation). Procedure/Surgery: Bariatric surgery Patients will undergo bariatric surgery as part of their routine care.	No Bariatric Surgery/Routine Exercise n=35 participants at risk Routine Exercise Patients will receive counseling regarding exercise as a routine part of their participation in the bariatric surgery clinic. Specifically, they are counseled to participate in 60 min of aerobic exercise daily in addition to 2-3 non-consecutive days of strength training workouts every wk. Patients are encouraged to contact the bariatric conditioning program, obtain a gym membership, purchase exercise equipment, join a walking group, and/or sign up for fitness classes (employer or city parks and recreation). Procedure/Surgery: None
Infections and infestations Infection at Skin Biopsy Site	0.00% 0/35 • 2 years Participants who withdrew from the study were not tracked after their withdrawal date	2.9% 1/35 • Number of events 1 • 2 years Participants who withdrew from the study were not tracked after their withdrawal date	2.9% 1/35 • Number of events 1 • 2 years Participants who withdrew from the study were not tracked after their withdrawal date	0.00% 0/35 • 2 years Participants who withdrew from the study were not tracked after their withdrawal date
Injury, poisoning and procedural complications Injury During Exercise	0.00% 0/35 • 2 years Participants who withdrew from the study were not tracked after their withdrawal date	2.9% 1/35 • Number of events 1 • 2 years Participants who withdrew from the study were not tracked after their withdrawal date	0.00% 0/35 • 2 years Participants who withdrew from the study were not tracked after their withdrawal date	0.00% 0/35 • 2 years Participants who withdrew from the study were not tracked after their withdrawal date

Additional Information

Brian Callaghan, MD

University of Michigan

Phone: 7349367183

Email: Bcallagh@med.umich.edu

Results disclosure agreements

• Principal investigator is a sponsor employee
• Publication restrictions are in place