The effect of high intensity interval training and surgical weight loss on distal symmetric polyneuropathy outcomes HUM00143541 Principal Investigator: Brian Callaghan, MD Clinical Research Coordinator: Ericka Chant, MPH

Purpose: To evaluate whether obesity and exercise cause neurologic changes in bariatric surgery patients Studies have demonstrated a relationship between weight loss from bariatric surgery and improved nerve health This study would help to determine if these improvements in nerve health can also be attained from exercise Understanding the effects of weight loss and exercise can lead to new treatments to prevent neuropathy, cognitive problems, and eye problems

Eligibility criteria - Age 40 and above - Weight less than 450 lbs - Determined as eligible for surgery by UM Bariatric Surgery clinic* - Not taking anticoagulants/blood thinners - Does not require a cane, walker, wheelchair, or other walking assist device - No current tobacco use - No current cancer treatment - No history of failed stress test *You do not have to have surgery in order to participate in the study

We need you!! Benefits of Participation: - Compensated for parking and your time (minimum $450, max $1720) - 50/50 chance of being placed in a group to work one-on-one with a personal trainer - Your lab results and exam information are provided to you - Learn more about your health and help others who currently suffer from neurologic diseases Risks are minimal – must pass a stress test to qualify for the study Long Term Goal: To develop treatments to prevent or reverse neurological problems associated with obesity

In this study, you will be randomized to one of two groups: 1) a standard exercise group, or 2) a personal training exercise group. Regardless of which group you are placed in, you would complete the following visits: Baseline visits Visit 1 (Screening): Stress/VO2 Test, 1 hour, $45 compensation Visit 2: Labs and DEXA scan, 1-3 hours, $25 compensation OPTIONAL Fat Biopsy, 30 mins, $25 compensation Visit 3: Labs and Testing, 4 hours, $100 compensation 3-month visit Visit 4: Labs and Testing, 3 hours, $100 compensation 1-year visit Visit 5: Labs and Testing, 3 hours, $100 compensation 2-year visit Visit 6: Labs and Testing, 4 hours, $100 compensation If you are placed in the personal training exercise group, you will be required to attend two 1-hour personal training sessions per week and one at-home exercise session per week for two years. Personal training exercise participants can earn an additional $1,200 based on training compliance/attendance, paid every two months over two years.

Interested in Participating? Contact: Ericka Chant (734) 936-8778 echant@med.umich.edu Emily Villegas-Umana (734) 936-8780 ligonemi@med.umich.edu We look forward to hearing from you!