In a recent study published in the journal Obesity Surgery, researchers found that baseline health-related quality of life (HRQL) was similar in patients with and without obesity-related disease prior to gastric bypass. The study also found that after surgery, patients with no comorbidity had similar positive changes in HRQL as patients with one or several comorbidities.
Severe obesity is associated with decreased health-related quality of life (HRQL) and social dysfunction. Gastric bypass is a commonly applied treatment in this patient group, enabling long-term weight loss and health improvements for most patients. Treatment with bariatric surgery is based on patient preference, and from the patients’ perspective, issues other than obesity-related comorbidities may be decisive for treatment preference in addition to obesity-related disease, such as weight, psychological factors, functional problems, and social dysfunction.
Studies have shown that HRQL varies in overweight and obese patients by treatment-seeking status, and patients seeking bariatric surgery have the most impaired HRQL. This may indicate that individuals opting for bariatric surgery suffer from a heavier psychosocial burden of their obese condition and that improvements in HRQL may be a main motivator for treatment choice.
Hilde Risstad from the Department of Endocrinology, Morbid Obesity and Preventive Medicine at Oslo University Hospital in Norway along with colleagues assessed HRQL in 232 severely obese patients before 1 year and 2 years after Roux-en-Y gastric bypass. The study aimed to compare HRQL before gastric bypass in patients with and without obesity-related disease, to evaluate and compare changes in HRQL 2 years after gastric bypass in the two patient groups, and to identify demographic and clinical variables that may have an impact on HRQL before surgery.
The researchers used a general HRQL questionnaire (Short Form 36), and an obesity-specific questionnaire (Obesity-related Problems scale). The patients were divided into two groups based on the presence of obesity-related disease (n=146) or not (n= 86) before surgery.
Obesity-related disease was defined as having at least one of the following conditions: type 2 diabetes mellitus, hypertension, dyslipidemia, coronary heart disease, obstructive sleep apnea, gastroesophageal reflux disease, or osteoarthritis. Results revealed that prior to surgery, patients that had no obesity-related disease reported identical HRQL in comparison to patients with obesity-related disease.
Two years following gastric bypass, the patients in both groups reported considerable improvements in all subscales of Short Form 36 and in Obesity-related Problems scale. The improvements were similar in 7 out of 8 subscales of Short Form 36 as well as for the Obesity-related Problems scale.
Based on the results, the researchers indicate other factors may be as relevant for the perception of health as the presence of obesity-related disease. According to the researchers the deteriorated HRQL in morbidly obese individuals and the aspects of improved HRQL after bariatric surgery may be an important patient driven motivation for surgery in otherwise metabolic and physically healthy obese subjects.