title: Health and health-related quality of life: differences between men and women who seek gastric bypass surgery.
abstract: BACKGROUND
  The aim of this study was to examine the differences between male and female bariatric surgery candidates with respect to health-related quality of life (HRQOL), health, sociodemographic variables, and interactions among these variables in a bariatric surgery practice in the United States. Women seek bariatric surgery 5 times more often than men. Research on gender differences in HRQOL is limited, and the results are conflicting.
  
  
  METHODS
  A total of 794 surgery candidates (mean age 42.2 y; body mass index 46.9 kg/m2; 84.8% women) completed both a weight-related (Impact of Weight on Quality of Life-Lite questionnaire) and a generic (Medical Outcomes Study Short-Form-36) measure of HRQOL. Health was evaluated by questionnaire and clinical interviews.
  
  
  RESULTS
  Compared to men, women reported reduced HRQOL on 3 of the 5 scales assessing obesity-specific HRQOL and also the physical aspects of general HRQOL. Women also had double the rate of depression (48.5% versus 22.5%), and men had double the rate of sleep apnea (80.3% versus 40.2%). Women were younger, less obese, and were less likely to be married. No gender differences were found in the association between HRQOL and co-morbidities. However, an increasing number of co-morbidities was associated with decreasing physical and mental HRQOL. Additionally, depression was associated with decreased mental HRQOL, and coronary heart disease was associated with decreased physical HRQOL.
  
  
  CONCLUSIONS
  Women's reduced HRQOL, particularly in self-esteem, sexual life, and physical functioning, and their greater rates of depression, might play a role in their decision to seek bariatric surgery. Although we could not determine causality, this study is a first step toward understanding why women seek surgery 5 times more often than men.
authors.affiliation: Obesity and Quality of Life Consulting, Durham, NC 27707, USA. rkolotkin@qualityoflifeconsulting.com
authors.forename: Ronette L
authors.initials: RL
authors.lastname: Kolotkin
authors.forename: Ross D
authors.initials: RD
authors.lastname: Crosby
authors.forename: Richard E
authors.initials: RE
authors.lastname: Gress
authors.forename: Steven C
authors.initials: SC
authors.lastname: Hunt
authors.forename: Scott G
authors.initials: SG
authors.lastname: Engel
authors.forename: Ted D
authors.initials: TD
authors.lastname: Adams
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001835:Body Weight; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000379:methods*; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D012737:Sex Factors; D011795:Surveys and Questionnaires; D014481:United States; D055815:Young Adult