title: Changes in Health-Related Quality of Life After Gastric Bypass in Patients With and Without Obesity-Related Disease.
abstract: BACKGROUND
  A substantial proportion of severely obese patients undergoing bariatric surgery have not developed disease as a consequence of obesity. Little is known about the effects of bariatric surgery on health-related quality of life (HRQL) in this patient group. In a prospective study at a public hospital, we compared HRQL in gastric bypass patients with and without obesity-related disease before and 2 years after surgery.
  
  
  METHODS
  HRQL was assessed in 232 severely obese patients before, 1 year, and 2 years after Roux-en-Y gastric bypass. We used a general HRQL questionnaire, the Short Form 36, and an obesity-specific questionnaire, the Obesity-related Problems scale. The patients were divided into two groups based on the presence of obesity-related disease (n = 146) or not (n = 86) before surgery. We defined obesity-related disease as having at least one of the following conditions: type 2 diabetes mellitus, hypertension, dyslipidemia, coronary heart disease, obstructive sleep apnea, gastroesophageal reflux disease, or osteoarthritis. Linear mixed models were used to analyze the HRQL outcomes.
  
  
  RESULTS
  Before surgery, patients with no obesity-related disease reported equal HRQL compared with patients with obesity-related disease. Two years after gastric bypass, substantial improvements in all subscales of Short Form 36 and in Obesity-related Problems scale were observed in both groups, and the improvements were similar in 7 out of 8 subscales of Short Form 36 as well as for the Obesity-related Problems scale.
  
  
  CONCLUSIONS
  Baseline HRQL was similar in patients with and without obesity-related disease prior to gastric bypass. After surgery, patients with no comorbidity had similar positive changes in HRQL as patients with one or several comorbidities. These findings indicate that other factors than obesity-related disease are at least as important for severely obese patients' impaired HRQL.
authors.affiliation: Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, P.O. Box 4959, Nydalen, 0424, Oslo, Norway. hiriss@outlook.com.
authors.forename: Hilde
authors.initials: H
authors.lastname: Risstad
authors.affiliation: Department of Gastrointestinal Surgery, Oslo University Hospital, Oslo, Norway. torgeir.sovik@gmail.com.
authors.forename: Torgeir T
authors.initials: TT
authors.lastname: Søvik
authors.affiliation: Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, P.O. Box 4959, Nydalen, 0424, Oslo, Norway. stehew@ous-hf.no.
authors.forename: Stephen
authors.initials: S
authors.lastname: Hewitt
authors.affiliation: Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, P.O. Box 4959, Nydalen, 0424, Oslo, Norway. joakri@ous-hf.no.
authors.forename: Jon A
authors.initials: JA
authors.lastname: Kristinsson
authors.affiliation: Oslo Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway. morten.fagerland@medisin.uio.no.
authors.forename: Morten W
authors.initials: MW
authors.lastname: Fagerland
authors.affiliation: Research and Development Department, Telemark Hospital Trust, Skien, Norway. tbernk@sthf.no.
authors.forename: Tomm
authors.initials: T
authors.lastname: Bernklev
authors.affiliation: Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, P.O. Box 4959, Nydalen, 0424, Oslo, Norway. tommal@ous-hf.no.
authors.forename: Tom
authors.initials: T
authors.lastname: Mala
mesh_terms: D000328:Adult; D003324:Coronary Artery Disease / Q000150:complications; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D050171:Dyslipidemias / Q000150:complications; D005260:Female; D015390:Gastric Bypass; D005764:Gastroesophageal Reflux / Q000150:complications; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D009767:Obesity, Morbid / Q000150:complications* / Q000601:surgery*; D010003:Osteoarthritis / Q000150:complications; D011446:Prospective Studies; D011788:Quality of Life; D020181:Sleep Apnea, Obstructive / Q000150:complications; D015431:Weight Loss
keywords: Bariatric surgery; Comorbidity; Gastric bypass; Health-related quality of life; Morbid obesity; OP-scale; SF-36; Severe obesity