Obesity Surgery

, Volume 20, Issue 3, pp 340–345 | Cite as

Health-Related Quality of Life and Paid Work Participation after Duodenal Switch

  • John Roger Andersen
  • Anny Aasprang
  • Per Bergsholm
  • Nils Sletteskog
  • Villy Våge
  • Gerd Karin Natvig
Clinical Research



Morbid obesity can reduce the health-related quality of life (HRQL) and paid work participation, and the duodenal switch (DS) can induce large weight loss in patients suffering from this disease. However, data about HRQL combined with paid work participation after duodenal switch are lacking. The aim of this study was to provide longitudinal data of these issues.


Fifty-one consecutive morbidly obese patients accepted for DS gave their informed consent to participate in the study. Mean age was 37.7 years (SD, 8.0), and 54.9% were women. HRQL was assessed using the “Short-Form 36 Health Status Survey”. Eight subscores, the physical component summary (PCS), and the mental component summary (MCS) were calculated. Paid-work participation was assessed as performing or not performing paid work. Data were assessed before DS (T0), 1 year after DS (T1), and 2 years after DS (T2).


All the SF-36 scores improved significantly from T0 to T1 and T2 (p < 0.001), when they were in the normal range compared to the population norm. The number of patients performing paid work increased from 28 (54.9%) at T0 to 34 (66.7%) at T2, p = 0.031. The patients who performed paid work had significantly better PCS and MCS scores than those who did not before, but not after, DS.


Our data indicate that the SF-36 scores of the patients were normalized after DS. A marked improvement in the paid work participation was also observed.


Health-related quality of life Morbid obesity Paid work participation Employment Bariatric surgery Duodenal switch 


  1. 1.
    Fontaine KR, Barofsky I. Obesity and health-related quality of life. Obes Rev. 2001;2:173–82.CrossRefPubMedGoogle Scholar
  2. 2.
    Neovius K, Johansson K, Rossner S, et al. Disability pension, employment and obesity status: a systematic review. Obes Rev. 2008;9:572–81.CrossRefPubMedGoogle Scholar
  3. 3.
    World Health Organization. European Ministerial Conference On Counteracting Obesity. Copenhagen, 2006. (Accessed 05.12. 2008, at http://www.euro.who.int/Document/NUT/Instanbul_conf_edoc06.pdf.)
  4. 4.
    Karlsson J, Taft C, Ryden A, et al. 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;31:1248–61.CrossRefGoogle Scholar
  5. 5.
    Wagner AJ, Fabry JM Jr, Thirlby RC. Return to work after gastric bypass in Medicaid-funded morbidly obese patients. Arch Surg. 2007;142:935–40.CrossRefPubMedGoogle Scholar
  6. 6.
    Hawkins SC, Osborne A, Finlay IG, et al. Paid work increases and state benefit claims decrease after bariatric surgery. Obes Surg. 2007;17:434–7.CrossRefPubMedGoogle Scholar
  7. 7.
    Velcu LM, Adolphine R, Mourelo R, et al. Weight loss, quality of life and employment status after Roux-en-Y gastric bypass: 5-year analysis. Surg Obes Relat Dis. 2005;1:413–6.CrossRefPubMedGoogle Scholar
  8. 8.
    Hess DS, Hess DW, Oakley RS. The biliopancreatic diversion with the duodenal switch: results beyond 10 years. Obes Surg. 2005;15:408–16.CrossRefPubMedGoogle Scholar
  9. 9.
    Weinera S, Sauerland S, Weiner RA, et al. Quality of life after bariatric surgery—is there a difference? Chir Gastroenterol. 2005;21:34–6.CrossRefGoogle Scholar
  10. 10.
    Perez N, Baltasar A, Serra C, et al. Comparative analysis of vertical banded gastroplasty and duodenal switch at five years follow-up. Obes Surg. 2005;15:1061–5.CrossRefPubMedGoogle Scholar
  11. 11.
    Marceau P, Biron S, Hould FS, et al. Duodenal switch: long-term results. Obes Surg. 2007;17:1421–30.CrossRefPubMedGoogle Scholar
  12. 12.
    Cramer JA, Spilker B. Quality of life and pharmacoeconomics an introduction. Philadelphia: Lippincott-Raven; 1998.Google Scholar
  13. 13.
    Wilson IB, Cleary PD. Linking clinical variables with health-related quality of life. A conceptual model of patient outcomes. JAMA. 1995;273:59–65.CrossRefPubMedGoogle Scholar
  14. 14.
    Ware JE, Kosinski M, Gandek B. SF-36 health survey: manual & interpretation guide. 2nd ed. Lincoln, RI: QualityMetric; 2000.Google Scholar
  15. 15.
    Loge JH, Kaasa S, Hjermstad MJ, et al. Translation and performance of the Norwegian SF-36 Health Survey in patients with rheumatoid arthritis. I. Data quality, scaling assumptions, reliability, and construct validity. J Clin Epidemiol. 1998;51:1069–76.CrossRefPubMedGoogle Scholar
  16. 16.
    Ware JE, Kosinksi M. SF-36 physical and mental health summary scales: a manual for users of version 1. Lincoln, RI: QualityMetric; 2001.Google Scholar
  17. 17.
    Simon GE, Revicki DA, Grothaus L, et al. SF-36 summary scores: are physical and mental health truly distinct? Med Care. 1998;36:567–72.CrossRefPubMedGoogle Scholar
  18. 18.
    Loge JH, Kaasa S. Short form 36 (SF-36) health survey: normative data from the general Norwegian population. Scand J Soc Med. 1998;26:250–8.PubMedGoogle Scholar
  19. 19.
    Statistics Norway. Work statistics. (Accessed 02.03. 2009, at http://www.ssb.no/arbeid/.)
  20. 20.
    Cohen J. Statistical power analysis for the behavioral sciences. New York: Academic; 1978.Google Scholar
  21. 21.
    Pinheiro J, Bates D. Mixed effects models in S and S-PLUS. New York: Springer; 2002.Google Scholar
  22. 22.
    Barnett AG, van der Pols JC, Dobson AJ. Regression to the mean: what it is and how to deal with it. Int J Epidemiol. 2005;34:215–20.CrossRefPubMedGoogle Scholar
  23. 23.
    Adami GF, Ramberti G, Weiss A, et al. Quality of life in obese subjects following biliopancreatic diversion. Behav Med. 2005;31:53–60.CrossRefPubMedGoogle Scholar
  24. 24.
    Choban PS, Onyejekwe J, Burge JC, et al. A health status assessment of the impact of weight loss following Roux-en-Y gastric bypass for clinically severe obesity. J Am Coll Surg. 1999;188:491–7.CrossRefPubMedGoogle Scholar
  25. 25.
    Carmichael AR, Sue-Ling HM, Johnston D. Quality of life after the Magenstrasse and Mill procedure for morbid obesity. Obes Surg. 2001;11:708–15.CrossRefPubMedGoogle Scholar
  26. 26.
    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.CrossRefPubMedGoogle Scholar
  27. 27.
    Ulset E, Undheim R, Malterud K. Has the obesity epidemic reached Norway? Tidsskr Nor Laegeforen. 2007;127:34–7.PubMedGoogle Scholar
  28. 28.
    Doll HA, Petersen SE, Stewart-Brown SL. Obesity and physical and emotional well-being: associations between body mass index, chronic illness, and the physical and mental components of the SF-36 questionnaire. Obes Res. 2000;8:160–70.CrossRefPubMedGoogle Scholar
  29. 29.
    Fine JT, Colditz GA, Coakley EH, et al. A prospective study of weight change and health-related quality of life in women. JAMA. 1999;282:2136–42.CrossRefPubMedGoogle Scholar
  30. 30.
    de Zwaan M, Lancaster KL, Mitchell JE, et al. Health-related quality of life in morbidly obese patients: effect of gastric bypass surgery. Obes Surg. 2002;12:773–80.CrossRefPubMedGoogle Scholar
  31. 31.
    Våge V, Solhaug JH, Viste A, Bergsholm P, et al. Anxiety, depression and health-related quality of life after jejunoileal bypass: a 25-year follow-up study of 20 female patients. Obes Surg. 2003;13:706–13.CrossRefPubMedGoogle Scholar
  32. 32.
    Biron S, Hould FS, Lebel S, et al. Twenty years of biliopancreatic diversion: what is the goal of the surgery? Obes Surg. 2004;14:160–4.CrossRefPubMedGoogle Scholar
  33. 33.
    Näslund E, Melin I, Gryback P, et al. Reduced food intake after jejunoileal bypass: a possible association with prolonged gastric emptying and altered gut hormone patterns. Am J Clin Nutr. 1997;66:26–32.PubMedGoogle Scholar
  34. 34.
    Ogden J, Clemeti C, Aylwin S. The impact of obesity surgery and the paradox of control: a qualitative study. Psychol Health. 2006;21:273–93.CrossRefGoogle Scholar
  35. 35.
    Marceau P, Cabanac M, Frankham PC, et al. Accelerated satiation after duodenal switch. Surg Obes Relat Dis. 2005;1:408–12.CrossRefPubMedGoogle Scholar
  36. 36.
    Jiang Y, Hesser JE. Associations between health-related quality of life and demographics and health risks. Results from Rhode Island's 2002 behavioral risk factor survey. Health Qual Life Outcome. 2006;4:14.CrossRefGoogle Scholar

Copyright information

© Springer Science + Business Media, LLC 2009

Authors and Affiliations

  • John Roger Andersen
    • 1
    • 4
  • Anny Aasprang
    • 1
  • Per Bergsholm
    • 2
  • Nils Sletteskog
    • 3
  • Villy Våge
    • 3
  • Gerd Karin Natvig
    • 4
  1. 1.Faculty of Health StudiesSogn and Fjordane University CollegeFørdeNorway
  2. 2.Department of PsychiatryFørde Central HospitalFørdeNorway
  3. 3.Department of SurgeryFørde Central HospitalFørdeNorway
  4. 4.Section of Nursing Science, Department of Public Health and Primary Health CareUniversity of BergenBergenNorway

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