To explore the effects of a social cognitive theory (SCT)-based exercise intervention on physical activity and related outcomes in adolescents after bariatric surgery. Methods A total of 70 adolescent patients who had undergone bariatric metabolic surgery and entered the follow-up management stage for 4 weeks postoperatively at the Department of Bariatric and Metabolic Surgery, the First Affiliated Hospital of Nanjing Medical University, between June 2023 and June 2024, were enrolled. They were randomly assigned to an experimental group (n=35) and a control group (n=35) using a random number table method. The control group received routine postoperative exercise guidance, while the intervention group received an SCT-based 16-week structured program focused on cognitive construction, behavioral execution, and environmental support. Outcomes, including physical activity levels, body composition, and psychosocial measures, were compared before and after the intervention. Results Compared with the control group, the intervention group showed significant improvements after the intervention in duration of moderate-to-vigorous physical activity (P=0.027), step count (P=0.010), BMI (P=0.037), excess weight loss rate (P=0.024), and the improvement in skeletal muscle mass percentage (P=0.043), quality of life (P=0.016), and exercise behavior intention (P=0.038), with statistically significant differences between the groups. However, no significant differences were observed between the groups in calorie expenditure, total activity duration, body fat percentage, or exercise self-efficacy (P>0.05). Conclusion SCT-based exercise interventions are effective in enhancing physical activity participation and psychosocial function in adolescents after bariatric surgery. This approach is feasible and adaptable, offering theoretical and practical support for postoperative behavioral management in this population.
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