The effects of weight loss after bariatric surgery on health-related quality of life and depression

Background: In severe obesity, impairments in health-related quality of life (HRQoL) and dysphoric mood are reported. This is a post-surgery analysis of the relationship between HRQoL and depressive symptoms, and weight change after four different types of bariatric procedures. Methods: A total of 105 consented patients completed the Short-Form-36 Health Survey (SF-36), the Impact of Weight on Quality of Life-Lite (IWQOL-Lite) and the Beck Depression Inventory (BDI) before and 25 months after surgery. Analysis of variance or Kruskal-Wallis test evaluated changes. Results: Patients with Roux-en Y gastric bypass (46 patients), decreased body mass indexes (BMIs; kgm^-2) 47-31 kgm^-2 (P<0.0001); biliopancreatic diversion with duodenal switch (18 patients), decreased BMIs 57-30 kgm^-2 (P<0.0001); adjustable gastric banding (18 patients), decreased BMIs 45-38 kgm^-2 (P<0.0001); and sleeve gastrectomies (23 patients), decreased BMIs 58 42 kgm^-2 (P<0.0001). The excess percentage BMI loss was 69, 89, 36 and 53 kgm^-2, respectively (P<0.0001). Before surgery, the SF-36 differences were significant regarding bodily pain (P = 0.008) and social functioning (P = 0.01). After surgery, physical function (P = 0.03), general health (P = 0.05) and physical component (P = 0.03) were different. IWQOL-Lite recorded no differences until after surgery: physical function (P = 0.003), sexual life (P = 0.04) and public distress (P = 0.003). BDI scores were not different for the four groups at baseline. All improved with surgery, 10.6-4.4 (P = 0.0001). Conclusions: HRQoL and depressive symptoms significantly improvement after surgery. These improvements do not have a differential effect over the wide range of weight change.

Duke Scholars

Author Ronette L Kolotkin Family Medicine and Community Health, Diet & Fitness Center