Health-related quality-of-life in patients with morbid obesity after gastric banding for surgically induced weight loss.
BACKGROUND
Physical, emotional, and social functioning are impaired in obesity. It is unknown whether and, if so, to what extent and in which domain obese subjects who lose weight may catch up to normal-weight levels. Our objective was to compare the health-related quality-of-life (HRQL) of obese subjects with that of a normal-weight reference group before and 1 year after a weight loss program that centered around laparoscopic and open gastric banding.


METHODS
An HRQL questionnaire consisting of a battery of both generic and specific measures was administered to 50 morbidly obese subjects on 2 occasions and to 100 healthy, normal-weight subjects, matched for age, gender, education, and vocational training. In addition to weight loss and health gain, the influences of achieved weight loss goals, satisfaction with outcome and operative approach (laparoscopy/laparotomy) were assessed.


RESULTS
Quality-of-life was significantly impaired in obese subjects. With a substantial weight loss of 35 kg and 42% loss of excessive weight, and correction of disturbed metabolic parameters, they significantly improved in general well-being, health distress, and perceived attractiveness, approaching halfway the values of a normal-weight reference group. Improvement in values for depression and self-regard lagged behind. In physical activity, they bypassed the reference group. Days of sick leave decreased to the level of the reference group. Improvements in HRQL paralleled the rate of weight loss. Personal satisfaction and surgical approach were of minor influence.


CONCLUSIONS
The obese subjects' impaired physical and social functioning improved considerably, catching up midway to normal-weight reference values after weight loss. Psychologic amelioration lagged behind. Whether the latter will catch up later and physical/social improvements will be maintained is the subject of further studies.
Mathus-Vliegen
Elisabeth M
EM
Department of Gastroenterology and Hepatology, Academic Medical Center, University of Amsterdam, Erasmus University of Rotterdam, and Onze Lieve Vrouwe Gasthuis, Amsterdam and Rotterdam, The Netherlands.
de Weerd
Sabina
S
de Wit
Laurens T
LT
D000328:Adult; D003863:Depression / Q000523:psychology; D005260:Female; D015390:Gastric Bypass / Q000379:methods; D015391:Gastroplasty; D006304:Health Status; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000503:physiopathology* / Q000523:psychology / Q000601:surgery*; D011184:Postoperative Period; D011788:Quality of Life; D012649:Self Concept; D016896:Treatment Outcome; D015431:Weight Loss