Quality of life after bariatric surgery: a population-based cohort study.
BACKGROUND
Bariatric surgery leads to profound weight loss, but postoperative complications and psychosocial issues may impact long-term quality of life. The primary aim of this project was to examine whether such patients have better quality of life and self-reported functional status compared with obese adults who do not have bariatric surgery.


METHODS
This population-based study of patients evaluated for Roux-en-Y gastric bypass surgery involved a survey consisting of baseline and follow-up single-item overall quality-of-life items (Linear Analogue Self-Assessment Questionnaire; LASA), follow-up quality of life (Short-Form-12), and activity (Goldman's Specific Activity Scale). A total of 268 and 273 surveys were mailed, with 148 (55.2%) operative and 88 (32.2%) nonoperative survey responders assessed, respectively. Linear regression was used, adjusting for changes in co-morbidity and functional status, to assess the differences in quality of life and activity level. Individual predictors of higher or better quality-of-life scores also were assessed.


RESULTS
There were no major differences in baseline characteristics between survey responders and nonresponders. Mean follow-up was 4.0 and 3.8 years in the operative and nonoperative groups, respectively. The change in overall LASA from baseline to follow-up between groups was 3.1 + or - 0.4 (P <.001). The adjusted Short-Form-12 score was 14.4 points higher in operative patients (P <.001) at follow-up. Operative patients had symptomatic improvement as measured by Specific Activity Scale status (odds ratio 7.5, P <.001) and self-reported exercise tolerance (odds ratio 2.61, P = .01) at follow-up compared with nonoperative patients. Predictors of a high follow-up LASA (P <.05) included initial treatment for depression, percent of weight lost, and absence of dyslipidemia and cardiovascular disease. Follow-up Short-Form-12 predictors included percent of weight loss, absence of baseline diabetes, baseline depression treatment, and follow-up cardiovascular disease.


CONCLUSIONS
Profound weight loss after bariatric surgery, seeking treatment for depression, and absence of medical co-morbidities appears to predict better quality of life and self-reported functional status.
Section of General Internal Medicine, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH 03765. john.batsis@gmail.com
John A
JA
Batsis
Francisco
F
Lopez-Jimenez
Maria L
ML
Collazo-Clavell
Matthew M
MM
Clark
Virend K
VK
Somers
Michael G
MG
Sarr
D050110:Bariatric Surgery / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000523:psychology / Q000601:surgery*; D011159:Population Surveillance; D011788:Quality of Life; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome