title: Quality of life and resolution of co-morbidities in super-obese patients remaining morbidly obese after Roux-en-Y gastric bypass.
abstract: BACKGROUND
  Not all patients undergoing Roux-en-Y gastric bypass with an initial body mass index (BMI) >50 kg/m(2) attain a BMI of <35 kg/m(2) postoperatively. We hypothesized that even though many of these patients remain morbidly obese after surgery, they still realize an improvement in co-morbidities and quality of life.
  
  
  METHODS
  Patients who had undergone Roux-en-Y gastric bypass and who had a preoperative BMI >50 kg/m(2) and postoperative BMI >35 kg/m(2) were identified. The records of 120 patients were reviewed for the presence of diabetes, hypertension, hyperlipidemia, and gastroesophageal reflux disease. Patients were queried about their use of medications, medical problems, and quality of life.
  
  
  RESULTS
  The average preoperative and postoperative BMI was 63.2 and 43.7 kg/m(2). Of the 120 patients, 77 responded to the survey. In the preoperative group, the rate of diabetes, hypertension, hyperlipidemia, and gastroesophageal reflux disease was 35%, 50.8%, 15%, and 34.2%, respectively. Postoperatively, 73.8%, 62.3%, 38.9%, and 87.8% of patients had been cured of these co-morbidities. The change in the incidence of diabetes, hypertension, and gastroesophageal reflux disease was significant at P = 0.0014, P = 0.037, and P <0.0001, respectively. More than 90% of patients considered themselves to be better postoperatively in the areas of overall health and ability to move about; 80-90% had improved ability to exercise, greater energy levels, more self esteem, and an improved physical appearance; 70-80% saw their ability to work and their social relationships as improved; and 56% believed their sexual relationships had improved.
  
  
  CONCLUSIONS
  Super-obese patients experience significant improvements in co-morbidities and quality of life after Roux-en-Y gastric bypass even if their BMI remains >35 kg/m(2).
authors.affiliation: Department of Surgery, University of Virginia Health System, Charlottesville, Virginia 22908-0709, USA.
authors.forename: John C
authors.initials: JC
authors.lastname: Bennett
authors.forename: Hongkun
authors.initials: H
authors.lastname: Wang
authors.forename: Bruce D
authors.initials: BD
authors.lastname: Schirmer
authors.forename: C Joe
authors.initials: CJ
authors.lastname: Northup
mesh_terms: D000713:Anastomosis, Roux-en-Y; D015992:Body Mass Index; D016009:Chi-Square Distribution; D015897:Comorbidity; D005260:Female; D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D008297:Male; D009767:Obesity, Morbid / Q000523:psychology* / Q000601:surgery*; D017060:Patient Satisfaction; D011788:Quality of Life; D016896:Treatment Outcome