Obesity Surgery

, Volume 19, Issue 8, pp 1124–1131 | Cite as

Changes in Quality of Life After Balloon Treatment Followed by Gastric Banding in Severely Obese Patients—The Use of Two Different Quality of Life Questionnaires

  • Sonja J. E. RuttenEmail author
  • Suzan de Goederen-van der Meij
  • Robert G. J. M. Pierik
  • Elisabeth M. H. Mathus-Vliegen
Research Article



Improvements in quality of life (QOL) obtained by weight loss have mainly been reported after bariatric surgery. QOL has not been investigated in surgical patients first losing weight by nonsurgical means followed by a surgical intervention and never simultaneously by two QOL—a generic and a disease-specific—questionnaires.


Prospective data were obtained from 40 consecutive patients (mean age 36.6 years, body weight 142.4 kg, body mass index (BMI) 46.5 kg/m2). Two different QOL questionnaires, the generic Medical Outcomes Study Short Form-36 (SF-36) and the disease-specific Health-Related Quality of Life (HRQL) questionnaire, were evaluated at three points in time: at the start, 3 months after the placement of an intragastric balloon that remained in situ for 6 months, and 3 months after subsequent gastric banding.


QOL scores revealed a significant improvement in many health domains, with an earlier improvement with the disease-specific HRQL, whereas the generic QOL questionnaire lagged behind. However, in the end, the SF-36 caught up completely to normal-weight levels, whereas some scales of the HRQL remained below these levels. Work productivity and involvement in sports improved significantly. BMI declined significantly over time, but no correlation with SF-36 and HRQL score changes was found.


The QOL improved substantially independent of changes in BMI. Because of the divergent outcomes of generic and disease-specific QOL questionnaires, prospective studies should examine the sensitivity to changes of both kinds of QOL questionnaires.


Intragastric balloon Laparoscopic gastric banding LAGB Quality of life Health-related quality of life (HRQL) SF-36 


  1. 1.
    Health Council of the Netherlands. Overweight and obesity. The Hague: Health Council of the Netherlands, 2003; publication no. 2003/07.Google Scholar
  2. 2.
    Larsen JK, Geenen R, van Ramshorst B, et al. Psychosocial functioning before and after laparoscopic adjustable gastric banding: a cross-sectional study. Obes Surg. 2003;13:629–36.CrossRefGoogle Scholar
  3. 3.
    Fabricatore AN, Wadden TA, Sarwer DB, et al. Health-related quality of life and symptoms of depression in extremely obese persons seeking bariatric surgery. Obes Surg. 2005;15:304–9.CrossRefGoogle Scholar
  4. 4.
    Sarwer DB, Wadden TA, Fabricatore AN. Psychosocial and behavioral aspects of bariatric surgery. Obes Res. 2005;13:639–48.CrossRefGoogle Scholar
  5. 5.
    Fabricatore AN, Wadden TA. Psychological aspects of obesity. Clin Dermatol. 2004;22:332–37.CrossRefGoogle Scholar
  6. 6.
    Van Hout GCM, van Oudheusden I, van Heck GL. Psychological profile of the morbidly obese. Obes Surg. 2004;14:579–88.CrossRefGoogle Scholar
  7. 7.
    Papageorgiou GM, Papakonstantinou A, Mamplekou E, et al. Pre- and postoperative psychological characteristics in morbidly obese patients. Obes Surg. 2002;12:534–9.CrossRefGoogle Scholar
  8. 8.
    Greenberg I, Perna F, Kaplan M, et al. Behavioral and psychological factors in the assessment and treatment of obesity surgery patients. Obes Res. 2005;13:244–9.CrossRefGoogle Scholar
  9. 9.
    Mathus-Vliegen EM. Overweight. II. Determinants of overweight and strategies for prevention. Ned Tijdschr Geneeskd. 1998;142:1989–95.PubMedGoogle Scholar
  10. 10.
    Mathus-Vliegen EM. Overweight. I. Prevalence and trends. Ned Tijdschr Geneeskd. 1998;142:1982–9.PubMedGoogle Scholar
  11. 11.
    Chapman AE, Kiroff G, Game P, et al. Laparoscopic adjustable gastric banding in the treatment of obesity: a systematic literature review. Surgery 2004;1345:326–51.CrossRefGoogle Scholar
  12. 12.
    Miller K. Obesity: surgical options. Best Pract Res Clin Gastroenterol. 2004;18:1147–65.CrossRefGoogle Scholar
  13. 13.
    O’Brien PE, Brown WA, Dixon JB. Obesity, weight loss and bariatric surgery. Med J Aust. 2005;183:310–4.Google Scholar
  14. 14.
    Ballantyne GH. Measuring outcomes following bariatric surgery: weight loss parameters, improvement in co-morbid conditions, change in quality of life and patient satisfaction. Obes Surg. 2003;13:954–64.CrossRefGoogle Scholar
  15. 15.
    Nguyen N, Varela EJ, Nguyen T, et al. Quality of life assessment in the morbidly obese. Obes Surg. 2006;16:531–3.CrossRefGoogle Scholar
  16. 16.
    Measuring Quality of Life: The development of the World Health Organization Quality of Life Instrument (WHOQOL). WHO, Geneva, 1993Google Scholar
  17. 17.
    Fontaine KR, Barofsky I. Obesity and health-related quality of life. Obes Rev. 2001;2:173–82.CrossRefGoogle Scholar
  18. 18.
    van Hout GC, van Oudheusden I, Krasuska AT, et al. Psychological profile of candidates for vertical banded gastroplasty. Obes Surg. 2006;16:67–74.CrossRefGoogle Scholar
  19. 19.
    Duval K, Marceau P, Lescelleur O, et al. Health-related quality of life in morbid obesity. Obes Surg. 2006;16:574–9.CrossRefGoogle Scholar
  20. 20.
    Sendi P, Brunotte R, Potoczna N, et al. Health-related quality of life in patients with class II and class III obesity. Obes Surg. 2005;15:1070–6.CrossRefGoogle Scholar
  21. 21.
    Kolotkin RL, Crosby RD, Pendleton R, et al. Health-related quality of life in patients seeking gastric bypass surgery vs non-treatment-seeking controls. Obes Surg. 2003;13:371–7.CrossRefGoogle Scholar
  22. 22.
    Kolotkin RL, Crosby RD, Williams GR. Health-related quality of life varies among obese subgroups. Obes Res. 2002;10:748–56.CrossRefGoogle Scholar
  23. 23.
    Freys SM, Tigges H, Heimbucher J, et al. Quality of life following laparoscopic gastric banding in patients with morbid obesity. J Gastrointest Surg. 2001;5:401–7.CrossRefGoogle Scholar
  24. 24.
    Dixon JB, Dixon ME, O’Brien PE. Quality of life after Lap-Band placement: influence of time, weight loss, and comorbidities. Obes Res. 2001;9:713–21.CrossRefGoogle Scholar
  25. 25.
    O’Brien PE, Dixon JB, Brown W, et al. The laparoscopic adjustable gastric band (Lap-Band®): a prospective study of medium-term effects on weight, health and quality of life. Obes Surg. 2002;12:652–60.CrossRefGoogle Scholar
  26. 26.
    van Gemert WG, Adang EM, Greve JWM, et al. Quality of life assessment of morbidly obese patients: effect of weight-reducing surgery. Am J Clin Nutr. 1998;67:197–201.CrossRefGoogle Scholar
  27. 27.
    Dixon JB, O’Brien PE. Changes in comorbidities and improvements in quality of life after LAP-BAND placement. Am J Surg. 2002;184:51S–4S.CrossRefGoogle Scholar
  28. 28.
    Ahroni JH, Montgomery KF, Watkins BM. Laparoscopic adjustable gastric banding: weight loss, co-morbidities, medication usage and quality of life at one year. Obes Surg. 2005;15:641–7.CrossRefGoogle Scholar
  29. 29.
    Tolonen P, Victorzon M, Mäkelä J. Impact of laparoscopic adjustable gastric banding for morbid obesity on disease-specific and health-related quality of life. Obes Surg. 2004;14:788–95.CrossRefGoogle Scholar
  30. 30.
    de Goederen - van der Meij S, Pierik EGJM, Oudkerk Pool M, et al. Six months of balloon treatment does not predict the success of gastric banding. Obes Surg. 2007;17:88–94.CrossRefGoogle Scholar
  31. 31.
    Aaronson NK, Muller MJ, Cohen PDA, et al. Translation, validation and norming of the Dutch language version of the SF-36 Health Survey in community and chronic disease populations. J Clin Epidemiol. 1998;51:1155–68.CrossRefGoogle Scholar
  32. 32.
    Guyatt GH, Feeny DH, Patrick DL. Measuring health-related quality of life. Ann Intern Med. 1993;18:622–9.CrossRefGoogle Scholar
  33. 33.
    Mathias SD, Fifer SK, Patrick DL. Rapid translation of quality of life measures for international clinical trials: avoiding errors in the minimalist approach. Qual Life Res. 1994;3:403–12.CrossRefGoogle Scholar
  34. 34.
    Mathias SD, Williamson CL, Colwell HH, et al. Assessing health-related quality-of-life and health state preference in persons with obesity: a validation study. Qual Life Res. 1997;6:311–22.CrossRefGoogle Scholar
  35. 35.
    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;135:489–97.CrossRefGoogle Scholar
  36. 36.
    Radloff LS. The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas. 2001;1:385–401.CrossRefGoogle Scholar
  37. 37.
    Herpertz S, Kielman R, Wolf AM, et al. Does obesity surgery improve psychosocial functioning? A systematic review. Int J Obes. 2003;27:1300–14.CrossRefGoogle Scholar
  38. 38.
    Hörchner R, Tuinebreijer W, Kelder H. Quality-of-life assessment of morbidly obese patients who have undergone a Lap-Band® operation: 2-year follow-up study. Is the MOS SF-36 a useful instrument to measure quality of life in morbidly obese patients? Obes Surg. 2001;11:212–8.CrossRefGoogle Scholar
  39. 39.
    Weiner R, Blanco-Engert R, Weiner S, et al. Outcome after laparoscopic adjustable gastric banding—8 years experience. Obes Surg. 2003;13:427–34.CrossRefGoogle Scholar
  40. 40.
    Mamplekou E, Komesidou V, Bissias C, et al. Psychological condition and quality of life in patients with morbid obesity before and after surgical weight loss. Obes Surg. 2005;15:1177–84.CrossRefGoogle Scholar
  41. 41.
    Waters GS, Pories WJ, Swanson MS, et al. Long-term studies of mental health after the Greenville gastric bypass operation for morbid obesity. Am J Surg. 1991;161:154–8.CrossRefGoogle Scholar
  42. 42.
    Mathus-Vliegen EMH, de Wit LT. Health-related quality of life after gastric banding. Br J Surg. 2007;94:457–65.CrossRefGoogle Scholar
  43. 43.
    Ware J. The status of health assessment 1994. Ann Rev Pub Health. 1995;16:327–54.CrossRefGoogle Scholar

Copyright information

© Springer Science + Business Media, LLC 2008

Authors and Affiliations

  • Sonja J. E. Rutten
    • 1
    Email author
  • Suzan de Goederen-van der Meij
    • 2
  • Robert G. J. M. Pierik
    • 3
  • Elisabeth M. H. Mathus-Vliegen
    • 4
  1. 1.Department of Medical PsychologyLeveste loc. ScheperziekenhuisEmmenThe Netherlands
  2. 2.Department of SurgeryNKI-AVLAmsterdamThe Netherlands
  3. 3.Department of SurgeryIsala KliniekenZwolleThe Netherlands
  4. 4.Department of GastroenterologyAcademic Medical CentreAmsterdamThe Netherlands

Personalised recommendations