title: Health-related quality of life after bariatric surgery: a systematic review of prospective long-term studies.
abstract: Impaired health-related quality of life (HRQoL) is common in bariatric surgery candidates and is often one of the motivating factors for seeking bariatric surgery. Although many studies have reported changes in HRQoL after bariatric surgery, few are long-term prospective studies and no systematic review has been conducted. A systematic database search identified studies reporting HRQoL preoperatively and≥5 years after bariatric surgery. Change in HRQoL over time was the outcome variable, divided into primary and secondary outcomes. Seven prospective cohort studies met the inclusion criteria. Eight HRQoL measures and 6 surgical methods were identified. Long-term follow-up time ranged from 5-10 years, sample sizes from 44 to 655 patients, and follow-up rates from 61% to 92%. None of the 7 studies were randomized controlled trials, and only 2 studies used control groups. Six of 7 studies showed statistically significant improvements in all of the primary outcomes, and 1 study showed statistically significant improvements in 1 of 2 primary outcomes. Of the statistically significant HRQoL improvements, 92% were clinically meaningful. Peak improvements in primary HRQoL outcomes were typically observed during the first years of follow-up, followed by a gradual decline that seemed to stabilize 5 years postoperatively. Long-term HRQoL scores typically remained improved relative to preoperative scores but were somewhat below population norm scores. In conclusion, while bariatric surgery candidates reported impaired HRQoL presurgically, their HRQoL improved considerably after bariatric surgery and much of the initial HRQoL improvements were maintained over the long term.
authors.affiliation: Department of Surgery, Førde Central Hospital, Førde, Norway; Faculty of Health Studies, Sogn og Fjordane University College, Førde, Norway. Electronic address: johnra@hisf.no.
authors.forename: John Roger
authors.initials: JR
authors.lastname: Andersen
authors.affiliation: Faculty of Health Studies, Sogn og Fjordane University College, Førde, Norway.
authors.forename: Anny
authors.initials: A
authors.lastname: Aasprang
authors.affiliation: Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway; Department of Health and Nursing Sciences, University of Agder, Grimstad, Norway.
authors.forename: Tor-Ivar
authors.initials: TI
authors.lastname: Karlsen
authors.affiliation: Faculty of Health Studies, Sogn og Fjordane University College, Førde, Norway; Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway.
authors.forename: Gerd Karin
authors.initials: GK
authors.lastname: Natvig
authors.affiliation: Department of Surgery, Førde Central Hospital, Førde, Norway.
authors.forename: Villy
authors.initials: V
authors.lastname: Våge
authors.affiliation: Department of Surgery, Førde Central Hospital, Førde, Norway; Faculty of Health Studies, Sogn og Fjordane University College, Førde, Norway; Morbid Obesity Centre, Vestfold Hospital Trust, Tønsberg, Norway; Quality of Life Consulting, Durham, North Carolina; Duke University School of Medicine, Durham, North Carolina.
authors.forename: Ronette L
authors.initials: RL
authors.lastname: Kolotkin
mesh_terms: D050110:Bariatric Surgery; D006801:Humans; D009767:Obesity, Morbid / Q000601:surgery; D011788:Quality of Life
keywords: Bariatric surgery; Health-related quality of life; Obesity; Quality of life; Systematic review