Elsevier

Surgery for Obesity and Related Diseases

Volume 6, Issue 5, September–October 2010, Pages 521-525
Surgery for Obesity and Related Diseases

Original article
Health-related quality of life does not vary among patients seeking different surgical procedures to assist with weight loss

https://doi.org/10.1016/j.soard.2010.03.291Get rights and content

Abstract

Background

Improvement in quality of life (QOL) is 1 of the goals of bariatric procedures. We hypothesized that greater impairment of QOL would encourage the choice of more invasive surgical procedures. Our study was performed at a university hospital weight loss surgical center in the United States.

Methods

Patients qualifying for weight loss surgery, who at their surgical consultation had chosen their surgical option and signed an informed consent form, were asked to complete 3 QOL forms—the Medical Outcomes Study Short Form 36-item Health Survey, the Beck Depression Inventory, and the Impact of Weight on Quality of Life-Lite. Analysis of variance was used to compare the surgery types with the demographics, QOL, and depression.

Results

A total of 367 patients, 114 men (31.1%) and 253 women (68.75), completed the QOL forms at their surgical consultation. Of these 367 patients, 68.9% elected gastric bypass (GB), 15% chose biliopancreatic diversion/duodenal switch (BPD/DS), and 16.1% chose adjustable gastric banding (AGB). The mean patient age was 42.5 ± 10.7 years (P = NS), with no differences in gender distribution. The body mass index was 51.9 kg/m2 for the BPD/DS group, greater than that for the GB group (45.9 kg/m2) or AGB group (44.3 kg/m2; P < .0001). No significant differences were found in the Beck Depression Inventory score among the 3 groups (GB 14.6 ± 9.6, AGB 10.8 ± 8.2, and BPD/DS 13.5 ± 7.3). For the Short Form 36-item Health Survey, only the physical component score was different for the AGB group compared with the BPD/DS group (GB 49.2 ± 25.1, BPD/DS 42.8 ± 26.4, and AGB 52.3 ± 31.7; P = .05). For the Impact of Weight on Quality of Life-Lite, all differences were nonsignificant. The total score was 44.1 ± 20.7, 44.4 ± 21.1, and 52.2 ± 19.6 for the GB, BPD/DS, and AGB groups, respectively.

Conclusion

Patients requesting a weight loss procedure reported moderate to severe impairments in QOL and mood dysphoria compared with the community norms. However, the patients choosing from the 3 procedures studied scored similarly on the health-related QOL assessments.

Section snippets

Procedures

The patients who qualified for surgically assisted weight loss according to the National Institutes of Health criteria [15] and who had chosen a surgical procedure were asked to review and sign an informed consent form approved by our institutional review board. At their surgical consultation they completed 3 forms to assess their QOL and mood dysphoria before surgery. Trained personnel reviewed the forms for completeness and performed the scoring.

Medical Outcomes Study Short Form 36-item Health Survey

The Medical Outcomes Study Short Form 36-item

Results

At their surgical consultation, 367 patients, 114 men (31.2%) and 253 women (68.8%), completed all 3 questionnaires before undergoing the procedure they had chosen. Table 1 lists the data on age, gender, and BMI of the 3 patient groups. No significant differences were found in the gender distribution or age of the patients requesting the 3 surgery types. The BMI differed significantly by surgery type (F = 22.97; df = 2363; P < .001). Post hoc comparisons revealed that the mean BMI for the

Discussion

Reviewing the published data, we found little information on differences in HRQOL and mood dysphoria related to the choice of surgical procedure to assist with weight loss. Because most surgical weight loss centers offer limited surgical options, patients' choices might be restricted. However, patients are known to seek out surgical centers related to the types of procedures that are offered. In some surgical centers, for research purposes, patients have agreed to a random assignment to a

Conclusion

Although patients choosing bariatric surgery reported moderate to severe impairments in QOL and symptoms of depression compared with community norms, their scores on the SF-36, IWQOL-Lite, and BDI did not generally differ among the 3 surgical groups. The BPD/DS group had a greater BMI and the adjustable AGB group had better overall physical HRQOL on the SF-36 than did the larger BPD/DS patients. From these observations, it is apparent that for these patients within this wide range of severe

Disclosures

The authors have no commercial associations that might be a conflict of interest in relation to this article.

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