title: Long-term health-related quality of life in bariatric surgery patients: A systematic review and meta-analysis.
abstract: OBJECTIVE
  Bariatric surgery results in significant weight loss in the majority of patients. Improvement in health-related quality of life (HRQoL) is an equally important outcome; however, there are few studies reporting long-term (≥5 years) HRQoL outcomes. This study assesses the quality of evidence and effectiveness of surgery on HRQoL ≥ 5 years.
  
  
  METHODS
  PubMed, Cochrane Review, EmBase, CINANL, PsycInfo, obesity conference abstracts, and reference lists were searched. Keywords were bariatric surgery, obesity, and quality of life. Studies were included if (1) there was ≥5 years follow-up, (2) patients had class II or III obesity, (3) individuals completed a validated HRQoL survey, and (4) there was a nonsurgical comparison group with obesity. Two reviewers independently assessed each study.
  
  
  RESULTS
  From 1376 articles, 9 studies were included in the systematic review (SR) and 6 in the meta-analysis (MA). Inconsistent results for long-term improvements in physical and mental health emerged from the SR. In contrast, the MA found significant improvements in these domains ≥5 years after surgery.
  
  
  CONCLUSIONS
  Study findings provide evidence for a substantial and significant improvement in physical and mental health favoring the surgical group compared with controls spanning 5 to 25 years after surgery.
authors.affiliation: Faculty of Medicine, Memorial University, Health Sciences Centre, St. John's, Newfoundland and Labrador, Canada.
authors.forename: Shannon
authors.initials: S
authors.lastname: Driscoll
authors.affiliation: Faculty of Medicine, Memorial University, Health Sciences Centre, St. John's, Newfoundland and Labrador, Canada.
authors.forename: Deborah M
authors.initials: DM
authors.lastname: Gregory
authors.affiliation: Faculty of Medicine, Memorial University, Health Sciences Centre, St. John's, Newfoundland and Labrador, Canada.
authors.forename: John M
authors.initials: JM
authors.lastname: Fardy
authors.affiliation: Faculty of Medicine, Memorial University, Health Sciences Centre, St. John's, Newfoundland and Labrador, Canada.|School of Pharmacy, Memorial University, Health Sciences Centre, St. John's, Newfoundland and Labrador, Canada.
authors.forename: Laurie K
authors.initials: LK
authors.lastname: Twells
mesh_terms: D000328:Adult; D050110:Bariatric Surgery / Q000523:psychology / Q000534:rehabilitation*; D006304:Health Status; D006801:Humans; D008603:Mental Health; D009765:Obesity / Q000523:psychology / Q000534:rehabilitation / Q000601:surgery*; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013997:Time Factors