Body contouring surgery improves long-term satisfaction with appearance and health-related quality of life after bariatric surgery: BODY-Q results from a Danish cohort study

Abstract

Background: Patient-reported outcomes are crucial in bariatric surgery (BaS) and body contouring surgery (BC) because patients’ goals include improvement in appearance and health-related quality of life (HR-QOL). The BODY-Q is a patient-reported outcome measure developed to measure change in satisfaction with appearance and HR-QOL in BaS and BC patients. The aim of this study was to examine BODY-Q scores over the entire weight loss journey, and to investigate the impact of BC after BaS. Methods: Patients completed the BODY-Q before and after BaS and BC at four hospital departments in Denmark between 2015 and 2019. Cross-sectional scores were analyzed by phase of weight loss journey using one-way analysis of variance. Scores for patients who provided longitudinal assessments were analyzed using repeated measures analysis of variance and paired t test. The impact of BC was examined over time after BaS, using an independent t test from before BaS through more than 7 years after BaS. Results: The study included 1527 patients who provided 2285 BODY-Q assessments. The cross-sectional analysis by phase of weight loss journey showed higher scores after BaS, lower scores before BC, and highest-level scores after BC. The longitudinal analysis showed higher postoperative mean scores compared with preoperative scores for both BaS and BC. The analysis over time after BaS revealed lower mean scores in patients who did not receive BC. Conclusion: The authors’ results provide evidence of the positive impact of BaS and BC on patients’ lives and emphasize the importance of considering BC to finalize the weight loss journey, as it helps to maintain improvements in appearance and HR-QOL. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

Body Contouring Surgery after Bariatric Surgery Improves Long-term Health-related Quality of Life and Satisfaction with Appearance

“…This study had a larger and longer follow-up period than our previous study. In contrast to this study, we previously did not observe significant differences between BS patients who later underwent BCS and those who only underwent BS until 3 to 4 years post surgery 48 . This indicates the importance of larger sample sizes and longer follow-ups to draw conclusions on the evidence of BCS.…”

“…Prior research has primarily focused on the short-term effects of BS and BCS in cross-sectional or short-term prospective studies. 14,15,35,48 Our BS findings align with Kvalem et al, 49 where over 90% of participants were satisfied with the results 1-year post surgery, while only 69% were satisfied and felt that their expectations of BS were met 5 years post surgery. Similarly, other studies using the BODY-Q showed that HRQL for patients undergoing BS improved most significantly within the first year after surgery and then gradually declined.…”

“…Prior research has primarily focused on the short-term effects of BS and BCS in cross-sectional or short-term prospective studies 14,15,35,48 . Our BS findings align with Kvalem et al, 49 where over 90% of participants were satisfied with the results 1-year post surgery, while only 69% were satisfied and felt that their expectations of BS were met 5 years post surgery.…”

“…In contrast to this study, we previously did not observe significant differences between BS patients who later underwent BCS and those who only underwent BS until 3 to 4 years post surgery. 48 This indicates the importance of larger sample sizes and longer follow-ups to draw conclusions on the evidence of BCS. To the best of our knowledge, this study is the largest up to 10-year longitudinal study to describe the changes in HRQL and satisfaction with appearance throughout the entire weight loss trajectory.…”