Health-related quality of life after bariatric surgery: a systematic review of prospective long-term studies

Abstract

Impaired health-related quality of life (HRQoL) is common in bariatric surgery candidates and is often one of the motivating factors for seeking bariatric surgery. Although many studies have reported changes in HRQoL after bariatric surgery, few are long-term prospective studies and no systematic review has been conducted. A systematic database search identified studies reporting HRQoL preoperatively and ≥ 5 years after bariatric surgery. Change in HRQoL over time was the outcome variable, divided into primary and secondary outcomes. Seven prospective cohort studies met the inclusion criteria. Eight HRQoL measures and six surgical methods were identified. Longterm follow-up time ranged from 5-10 years, sample sizes from 44 to 655 patients, and follow-up rates from 61 to 92%. None of the seven studies were randomized controlled trails and only two studies used control groups. Six out of seven studies showed statistically significant improvements in all of the primary outcomes, while one study showed statistically significant improvements in one of two primary outcomes. Of the statistically significant HRQoL improvements, 92 percent were clinically meaningful. Peak improvements in primary HRQoL outcomes were typically observed during the first years of follow-up, followed by a gradual decline that seemed to stabilize five years postoperatively. Long-term HRQoL scores typically remained improved relative to preoperative scores but were somewhat below population norm scores. In conclusion, while bariatric surgery candidates reported impaired HRQoL pre-surgically, their HRQoL improved considerably after bariatric surgery and much of the initial HRQoL improvements were maintained over the long term.

Outcomes of the Ontario Bariatric Network: a cohort study

“…9 Studies have also shown a 50% reduction in mortality after bariatric surgery and an improvement in the quality of life of patients that accompanies their weight loss and improvement in overall health. 10,11 The objective of this study was to publish short-term outcomes after bariatric surgery in Canada's largest regional bariatric surgery program, and to compare short-term outcomes between sites. We hypothesize that outcomes of the Ontario Bariatric Network would be similar to other major international centres, with little variation across centres within the program.…”

Ten-year changes in health-related quality of life after biliopancreatic diversion with duodenal switch

“…Compared to gastric bypass, BPDDS is associated with higher loss and remission rates for metabolic diseases [10]. A recent systematic review identified seven prospective cohort studies reporting HRQL both preoperatively and > five years after bariatric surgery [11]. Of these studies, only one reported 10-year HRQL data, but no studies included BPDDS [12].…”

Psychosomatic and Psychosocial Questions Regarding Bariatric Surgery: What Do We Know, or What Do We Think We Know?

“…No relationship emerged between weight loss and psychological QoL, a finding that was confirmed by other cohort studies with longer follow-up periods Kolotkin et al 2012;Herpertz et al 2015). Andersen et al (2015) conducted a systematic review on the QoL of bariatric surgery patients, and included studies with a follow-up of at least five years only. Overall, seven studies were considered Mathus-Vliegen 2007;Helmiö et al 2011;Schouten et al 2011;Kolotkin et al 2012;Zijlstra et al 2013;Aasprang et al 2013), comprising a total of 1,113 patients, observation periods from 5 to 10 years, and follow-up rates from 61% to 92%.…”