Mortality, weight loss and quality of life of patients with morbid obesity: evaluation of the surgical and medical treatment after 2 years

Abstract

-Context -The surgical treatment for morbid obesity is becoming common in this country. Only a few papers reported the long-term results of the surgical approach for morbid obesity, mainly in terms of quality of life. Objective -To compare mortality rate, weight loss, improvement of both diabetes and hypertension, and quality of life of patients from the public healthcare in Cuiabá, MT, Brazil, who underwent either medical or surgical interventions after a minimum of 2 years. Methods -The population of this study was constituted by morbidly obese patients who initiated treatment between June 2002 and December 2006. The casuistic consisted of 89 patients submitted to medical therapy and 76 patients who underwent surgical procedures. The main variables were weight loss, improvement of hypertension and diabetes, quality of life, and mortality. Results -The overall results showed that weight loss was significant in the two groups (P<0.001); however surgical patients showed a greater loss than the medical group (P = 0.05). The improvement of diabetes and hypertension was significantly greater in the surgical group (P<0.001), in which no cases of diabetes persisted. There was an increase in cases of hypertension among patients receiving medical attention. Mortality occurred in six cases (6.7%) of the medical group and in five cases (6.6%) of the surgical group (P = 0.97). The median grade of the quality of life score obtained by surgical patients (2.37 [range: -2.50 to 3.00]) was significantly greater (P<0.001) when compared to the medical group (1.25 [range: -1.50 to 3.00]). Conclusion -The surgical group presented better results regarding the weight loss, quality of life and improvement of hypertension and diabetes. There was no significant difference in mortality rate between the two groups after a minimum of 2 years.

Avaliação da qualidade de vida tardia após gastroplastia vertical

“…When there is therapeutic failure there is the option of surgical treatment for patients with associated chronic diseases (BMI between 35 and 40kg/ m 2 ) and/or morbidly obese (BMI above 40kg/m 2 ) 3 . Clinical management of obesity is difficult, for not only weight loss, but mainly conservation of achieved weight, is not possible for most morbid obese 4 . From the middle of the twentieth century on began the surgical treatment of obesity 5,6 , which can be done with restrictive, disabsortive and mixed techniques 7,8 .…”

Evaluación de un programa ministerial para manejo del síndrome metabólico en adultos con sobrepeso y obesidad

“…Asimismo, en la evaluación nacional del PASAF publicada el año 2008, 40% disminuyó ≥ 5% de su peso 11 y en el piloto del programa (año 2004) 55% redujo este porcentaje, con medianas de cambio de peso e IMC tres veces superiores a las halladas en este estudio 8 . Es posible que la diferencia en los resultados se deba a que este estudio incluyó a participantes con obesidad mórbida, en quienes las intervenciones no quirúrgicas son menos exitosas 21,22 . Otros factores que pueden explicar esta diferencia son: la baja adherencia a los talleres y el menor número de controles por médico (uno) en relación al programa piloto (tres), pudiendo esto influir en una mayor motivación en los participantes 8 .…”

Psychological Disturbances and Quality of Life in Obese and Infertile Women and Men

“…It should be emphasized that BMI affects the HRQoL independently of questionnaire used to its assessment [149]. In morbid obese significant improvement of HRQoL, both physical and psychological aspects as well as self-esteem, social life, sexual activity, and disposition for physical activities or work, after surgical treatment of obesity with large weight loss were obtained [150–152]. Regardless of the observed improvement in HRQoL and disease-specific quality of life (DSQoL) one-year after procedure and their maintenance during 5-year followup the HRQoL values are lower than in age- and gender-matched general population [153].…”