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Quality of Life After Bariatric Surgery

  • Obesity Treatment (CM Apovian, Section Editor)
  • Published:
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Abstract

Purpose of Review

The purpose of this review is to provide an introduction to quality of life (QOL) outcomes after bariatric surgery and a summary of the current evidence.

Recent Findings

QOL has been emphasized in bariatric surgery since the NIH Consensus Conference statement in 1991. Initial studies were limited to 1- and 2-year follow-up. More recent findings have expanded the follow-up period up to 12 years, providing a better description of the impact on long-term QOL. Overall, there is little to no consensus regarding the definition of QOL or the ideal survey. Bariatric surgery has the greatest impact on physical QOL, and the impact on mental health remains unclear. There are some specific and less frequently reported threats to quality of life after bariatric surgery that are also discussed.

Summary

Obesity has a definite impact on quality of life, even without other comorbidities, and surgery for obesity results in significant and lasting improvements in patient-reported quality of life outcomes. This conclusion is limited by a wide variety of survey instruments and absence of consensus on the definition of QOL after bariatric surgery.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. Organization WH. Fact sheet: obesity and overweight 2016.

  2. Fontaine KR, Bartlett SJ, Barofsky I. Health-related quality of life among obese persons seeking and not currently seeking treatment. Int J Eat Disord. 2000;27(1):101–5.

    Article  CAS  PubMed  Google Scholar 

  3. Statement NC. Gastrointestinal surgery for severe obesity. 1991;9(1):1–20.

  4. Oria HE, Moorehead MK. Bariatric analysis and reporting outcome system (BAROS). Obes Surg. 1998;8(5):487–99.

    Article  CAS  PubMed  Google Scholar 

  5. Hamming JF, De Vries J. Measuring quality of life. Br J Surg. 2007;94(8):923–4.

    Article  CAS  PubMed  Google Scholar 

  6. Fletcher A. Quality-of-life measurements in the evaluation of treatment: proposed guidelines. Br J Clin Pharmacol. 1995;39(3):217–22.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Coulman KD, Abdelrahman T, Owen-Smith A, Andrews RC, Welbourn R, Blazeby JM. Patient-reported outcomes in bariatric surgery: a systematic review of standards of reporting. Obes Rev. 2013;14(9):707–20.

    Article  CAS  PubMed  Google Scholar 

  8. Jumbe S, Bartlett C, Jumbe SL, Meyrick J. The effectiveness of bariatric surgery on long term psychosocial quality of life—a systematic review. Obes Res Clin Pract. 2016;10(3):225–42.

    Article  PubMed  Google Scholar 

  9. Mathus-Vliegen EM, de Wit LT. Health-related quality of life after gastric banding. Br J Surg. 2007;94(4):457–65.

    Article  CAS  PubMed  Google Scholar 

  10. Sanchez-Santos R, Del Barrio MJ, Gonzalez C, Madico C, Terrado I, Gordillo ML, et al. Long-term health-related quality of life following gastric bypass: influence of depression. Obes Surg. 2006;16(5):580–5.

    Article  PubMed  Google Scholar 

  11. Himpens J, Dobbeleir J, Peeters G. Long-term results of laparoscopic sleeve gastrectomy for obesity. Ann Surg. 2010;252(2):319–24.

    Article  PubMed  Google Scholar 

  12. Himpens J, Verbrugghe A, Cadiere GB, Everaerts W, Greve JW. Long-term results of laparoscopic Roux-en-Y gastric bypass: evaluation after 9 years. Obes Surg. 2012;22(10):1586–93.

    Article  PubMed  Google Scholar 

  13. Myers JA, Clifford JC, Sarker S, Primeau M, Doninger GL, Shayani V. Quality of life after laparoscopic adjustable gastric banding using the Baros and Moorehead-Ardelt Quality of Life Questionnaire II. JSLS. 2006;10(4):414–20.

    PubMed  PubMed Central  Google Scholar 

  14. Amichaud R, Donatini G, Barussaud ML, Charalambous C, Ingrand I, Faure JP. Health-related quality of life after laparoscopic sleeve gastrectomy. A multicentric experience. Minerva Chir. 2016;71(4):245–51.

    PubMed  Google Scholar 

  15. • Peterli R, Borbely Y, Kern B, Gass M, Peters T, Thurnheer M, et al. Early results of the Swiss Multicentre Bypass or Sleeve Study (SM-BOSS): a prospective randomized trial comparing laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass. Ann Surg. 2013;258(5):690–4. discussion 5. This prospective trial demonstrated the weight loss and quality of life differences between the 2 major surgeriesfor weight loss.

  16. Inge TH, Courcoulas AP, Jenkins TM, Michalsky MP, Helmrath MA, Brandt ML, et al. Weight loss and health status 3 years after bariatric surgery in adolescents. N Engl J Med. 2016;374(2):113–23.

    Article  CAS  PubMed  Google Scholar 

  17. Strain GW, Kolotkin RL, Dakin GF, Gagner M, Inabnet WB, Christos P, et al. The effects of weight loss after bariatric surgery on health-related quality of life and depression. Nutr Diabetes. 2014;4:e132.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Burgmer R, Legenbauer T, Muller A, de Zwaan M, Fischer C, Herpertz S. Psychological outcome 4 years after restrictive bariatric surgery. Obes Surg. 2014;24(10):1670–8.

    Article  PubMed  Google Scholar 

  19. Sarwer DB, Wadden TA, Moore RH, Eisenberg MH, Raper SE, Williams NN. Changes in quality of life and body image after gastric bypass surgery. Surg Obes Relat Dis. 2010;6(6):608–14.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Steffen KJ, Sarwer DB, Thompson JK, Mueller A, Baker AW, Mitchell JE. Predictors of satisfaction with excess skin and desire for body contouring after bariatric surgery. Surg Obes Relat Dis. 2012;8(1):92–7.

    Article  PubMed  Google Scholar 

  21. The World Health Organization Quality of Life Assessment (WHOQOL): development and general psychometric properties. Soc Sci Med. 1998;46(12):1569–85.

  22. Wee CC, Davis RB, Huskey KW, Jones DB, Hamel MB. Quality of life among obese patients seeking weight loss surgery: the importance of obesity-related social stigma and functional status. J Gen Intern Med. 2013;28(2):231–8.

    Article  PubMed  Google Scholar 

  23. Michelson H, Bolund C, Nilsson B, Brandberg Y. Health-related quality of life measured by the EORTC QLQ-C30—reference values from a large sample of Swedish population. Acta Oncol. 2000;39(4):477–84.

    Article  CAS  PubMed  Google Scholar 

  24. Mathus-Vliegen EM, de Weerd S, de Wit LT. Health-related quality-of-life in patients with morbid obesity after gastric banding for surgically induced weight loss. Surgery. 2004;135(5):489–97.

    Article  PubMed  Google Scholar 

  25. Batsis JA, Lopez-Jimenez F, Collazo-Clavell ML, Clark MM, Somers VK, Sarr MG. Quality of life after bariatric surgery: a population-based cohort study. Am J Med. 2009;122(11):1055 e1–e10.

    Article  Google Scholar 

  26. Bocchieri LE, Meana M, Fisher BL. A review of psychosocial outcomes of surgery for morbid obesity. J Psychosom Res. 2002;52(3):155–65.

    Article  PubMed  Google Scholar 

  27. • Kolotkin RL, Davidson LE, Crosby RD, Hunt SC, Adams TD. Six-year changes in health-related quality of life in gastric bypass patients versus obese comparison groups. Surg Obes Relat Dis. 2012;8(5):625–33. This study shows the longest term quality of life improvement for bariatric surgery patients compared to obese controls.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Kolotkin RL, Crosby RD, Gress RE, Hunt SC, Adams TD. Two-year changes in health-related quality of life in gastric bypass patients compared with severely obese controls. Surg Obes Relat Dis. 2009;5(2):250–6.

    Article  PubMed  Google Scholar 

  29. Ding SA, Simonson DC, Wewalka M, Halperin F, Foster K, Goebel-Fabbri A, et al. Adjustable gastric band surgery or medical management in patients with type 2 diabetes: a randomized clinical trial. J Clin Endocrinol Metab. 2015;100(7):2546–56.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Halperin F, Ding SA, Simonson DC, Panosian J, Goebel-Fabbri A, Wewalka M, et al. Roux-en-Y gastric bypass surgery or lifestyle with intensive medical management in patients with type 2 diabetes: feasibility and 1-year results of a randomized clinical trial. JAMA Surg. 2014;149(7):716–26.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Adams TD, Davidson LE, Litwin SE, Kolotkin RL, LaMonte MJ, Pendleton RC, et al. Health benefits of gastric bypass surgery after 6 years. JAMA. 2012;308(11):1122–31.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. Raoof M, Naslund I, Rask E, Karlsson J, Sundbom M, Edholm D, et al. Health-related quality-of-life (HRQoL) on an average of 12 years after gastric bypass surgery. Obes Surg. 2015;25(7):1119–27.

    Article  PubMed  Google Scholar 

  33. Laurino Neto RM, Herbella FA. Changes in quality of life after short and long term follow-up of Roux-en-Y gastric bypass for morbid obesity. Arq Gastroenterol. 2013;50(3):186–90.

    Article  PubMed  Google Scholar 

  34. Buddeberg-Fischer B, Klaghofer R, Krug L, Buddeberg C, Muller MK, Schoeb O, et al. Physical and psychosocial outcome in morbidly obese patients with and without bariatric surgery: a 4 1/2-year follow-up. Obes Surg. 2006;16(3):321–30.

    Article  PubMed  Google Scholar 

  35. Karlsson J, Taft C, Ryden A, Sjostrom L, Sullivan M. Ten-year trends in health-related quality of life after surgical and conventional treatment for severe obesity: the SOS intervention study. Int J Obes. 2007;31(8):1248–61.

    Article  CAS  Google Scholar 

  36. Schauer PR, Bhatt DL, Kirwan JP, Wolski K, Brethauer SA, Navaneethan SD, et al. Bariatric surgery versus intensive medical therapy for diabetes—3-year outcomes. N Engl J Med. 2014;370(21):2002–13.

    Article  PubMed  Google Scholar 

  37. Dixon JB, Dixon ME, O'Brien PE. Quality of life after lap-band placement: influence of time, weight loss, and comorbidities. Obes Res. 2001;9(11):713–21.

    Article  CAS  PubMed  Google Scholar 

  38. Campos GM, Rabl C, Roll GR, Peeva S, Prado K, Smith J, et al. Better weight loss, resolution of diabetes, and quality of life for laparoscopic gastric bypass vs banding: results of a 2-cohort pair-matched study. Arch Surg. 2011;146(2):149–55.

    Article  PubMed  Google Scholar 

  39. Hell E, Miller KA, Moorehead MK, Norman S. Evaluation of health status and quality of life after bariatric surgery: comparison of standard Roux-en-Y gastric bypass, vertical banded gastroplasty and laparoscopic adjustable silicone gastric banding. Obes Surg. 2000;10(3):214–9.

    Article  CAS  PubMed  Google Scholar 

  40. Romy S, Donadini A, Giusti V, Suter M. Roux-en-Y gastric bypass vs gastric banding for morbid obesity: a case-matched study of 442 patients. Arch Surg. 2012;147(5):460–6.

    Article  PubMed  Google Scholar 

  41. Rea JD, Yarbrough DE, Leeth RR, Leath TD, Clements RH. Influence of complications and extent of weight loss on quality of life after laparoscopic Roux-en-Y gastric bypass. Surg Endosc. 2007;21(7):1095–100.

    Article  CAS  PubMed  Google Scholar 

  42. Schouten R, Wiryasaputra DC, van Dielen FM, van Gemert WG, Greve JW. Influence of reoperations on long-term quality of life after restrictive procedures: a prospective study. Obes Surg. 2011;21(7):871–9.

    Article  PubMed  PubMed Central  Google Scholar 

  43. de Zwaan M, Enderle J, Wagner S, Muhlhans B, Ditzen B, Gefeller O, et al. Anxiety and depression in bariatric surgery patients: a prospective, follow-up study using structured clinical interviews. J Affect Disord. 2011;133(1–2):61–8.

    Article  PubMed  Google Scholar 

  44. Magallares A, Schomerus G. Mental and physical health-related quality of life in obese patients before and after bariatric surgery: a meta-analysis. Psychol Health Med. 2015;20(2):165–76.

    Article  PubMed  Google Scholar 

  45. Groven KS, Raheim M, Engelsrud G. “My quality of life is worse compared to my earlier life”: living with chronic problems after weight loss surgery. Int J Qual Stud Health Well-being. 2010;5(4):5553.

    Article  Google Scholar 

  46. Sarwer DB, Fabricatore AN, Eisenberg MH, Sywulak LA, Wadden TA. Self-reported stigmatization among candidates for bariatric surgery. Obesity (Silver Spring). 2008;16(Suppl 2):S75–9.

    Article  Google Scholar 

  47. Kitzinger HB, Abayev S, Pittermann A, Karle B, Kubiena H, Bohdjalian A, et al. The prevalence of body contouring surgery after gastric bypass surgery. Obes Surg. 2012;22(1):8–12.

    Article  PubMed  Google Scholar 

  48. Kitzinger HB, Abayev S, Pittermann A, Karle B, Bohdjalian A, Langer FB, et al. After massive weight loss: patients’ expectations of body contouring surgery. Obes Surg. 2012;22(4):544–8.

    Article  PubMed  Google Scholar 

  49. Hurwitz DJ, Ayeni O. Body contouring surgery in the massive weight loss patient. Surg Clin North Am. 2016;96(4):875–85.

    Article  PubMed  Google Scholar 

  50. Ellison JM, Steffen KJ, Sarwer DB. Body contouring after bariatric surgery. Eur Eat Disord Rev. 2015;23(6):479–87.

    Article  PubMed  Google Scholar 

  51. Modarressi A, Balague N, Huber O, Chilcott M, Pittet-Cuenod B. Plastic surgery after gastric bypass improves long-term quality of life. Obes Surg. 2013;23(1):24–30.

    Article  CAS  PubMed  Google Scholar 

  52. Mitchell JE, Lancaster KL, Burgard MA, Howell LM, Krahn DD, Crosby RD, et al. Long-term follow-up of patients’ status after gastric bypass. Obes Surg. 2001;11(4):464–8.

    Article  CAS  PubMed  Google Scholar 

  53. King WCCJ, Mitchell JE, Kalarchian MA, Steffen KJ, Engel SG, Courcoulas AP, Pores WJ, Yanovski SZ. Prevalence of alcohol use disorders before and after bariatric surgery. JAMA. 2012;307(23):2516–25.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  54. Woodard GA, Downey J, Hernandez-Boussard T, Morton JM. Impaired alcohol metabolism after gastric bypass surgery: a case-crossover trial. J Am Coll Surg. 2011;212(2):209–14.

    Article  PubMed  Google Scholar 

  55. Steffen KJ, Engel SG, Wonderlich JA, Pollert GA, Sondag C. Alcohol and other addictive disorders following bariatric surgery: prevalence, risk factors and possible etiologies. Eur Eat Disord Rev. 2015;23(6):442–50.

    Article  PubMed  Google Scholar 

  56. Jia H, Lubetkin EI. The impact of obesity on health-related quality-of-life in the general adult US population. J Public Health (Oxf). 2005;27(2):156–64.

    Article  Google Scholar 

  57. Balsiger BM, Poggio JL, Mai J, Kelly KA, Sarr MG. Ten and more years after vertical banded gastroplasty as primary operation for morbid obesity. J Gastrointest Surg. 2000;4(6):598–605.

    Article  CAS  PubMed  Google Scholar 

  58. Wang W, Yu PJ, Lee YC, Wei PL, Lee WJ. Laparoscopic vertical banded gastroplasty: 5-year results. Obes Surg. 2005;15(9):1299–303.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Division of General Surgery, Department of Surgery, Stanford University School of Medicine, Stanford University, 300 Pasteur Drive, H3591, Stanford, CA, 94305-5655, USA

    Laura M. Mazer

  2. Section of Bariatric and Minimally Invasive Surgery, Stanford University School of Medicine, Stanford University, 300 Pasteur Drive, H3680A, Stanford, CA, 94305-5655, USA

    Dan E. Azagury & John M. Morton

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  1. Laura M. Mazer
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  2. Dan E. Azagury
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  3. John M. Morton
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Correspondence to John M. Morton.

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Laura M. Mazer, Dan E. Azagury, and John M. Morton declare they have no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Obesity Treatment

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Mazer, L.M., Azagury, D.E. & Morton, J.M. Quality of Life After Bariatric Surgery. Curr Obes Rep 6, 204–210 (2017). https://doi.org/10.1007/s13679-017-0266-7

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