Health-related quality-of-life in patients with morbid obesity after gastric banding for surgically induced weight loss

Mathus-Vliegen, Elisabeth M. H.; Weerd, Sabina de; Wit, L. T. de

doi:10.1016/j.surg.2004.01.007

Cited by 70 publications

(45 citation statements)

References 41 publications

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“…Various forms of the SF-36 s have been used in multiple studies of GBS populations, demonstrating consistent improvement with weight loss as early as a few weeks post-operatively. [39][40][41][42][43] Our subjects' results were consistent with these findings. The SF-36 s has been recommended at a consensus conference of bariatric surgeons 44 and the SF-12 s has demonstrated internal validity in a bariatric population.…”

Section: Discussionsupporting

confidence: 90%

Musculoskeletal findings in obese subjects before and after weight loss following bariatric surgery

et al. 2006

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Objective: To determine the point prevalence of painful musculoskeletal (MSK) conditions in obese subjects before and after weight loss following bariatric surgery. Design: Longitudinal, interventional, unblended. Subjects: Forty-eight obese subjects (47 women, one man, mean age 4479 years; mean body mass index (BMI) 5178 kg/m 2 ) recruited from an academic medical center bariatric surgery program. Measurements: Comorbid medical conditions; MSK findings; BMI; Western Ontario McMaster Osteoarthritis Index (WOMAC) for pain, stiffness and function; and SF-36 s for quality of life. Methods: Consecutive subjects were recruited from the University Hospitals of Cleveland Bariatric Surgery Program. Musculoskeletal signs and symptoms and non-MSK comorbid conditions were documented at baseline and at follow-up. Subjects completed the SF-36 s and the WOMAC questionnaires. Analyses were carried out for each MSK site, fibromyalgia syndrome (FMS) and for the cumulative effect on the spine, upper and lower extremities. The impact of change in comorbid medical conditions, BMI, physical and mental health domains of the SF-36 s on the WOMAC pain subscale score was evaluated. SF-36 s outcomes were compared to normal published controls. Results: Forty-eight subjects were available for baseline and a follow-up assessment 6-12 months after gastric bypass surgery. They lost an average of 41715 kg and the mean BMI decreased from 5178 to 3677 kg/m 2 . Baseline comorbid medical conditions were present in 96% before surgery and 23% after weight loss. There was an increased prevalence of painful MSK conditions at baseline compared to general population frequencies. Musculoskeletal complaints had been present in 100% of obese subjects before, and 23% after weight loss. The greatest improvements occurred in the cervical and lumbar spine, the foot and in FMS (decreased by 90, 83, 83 and 92%, respectively). Seventy-nine percent had upper extremity MSK conditions before and 40% after weight loss. Before surgery, 100% had lower extremity MSK conditions and only 37% did after weight loss. The WOMAC subscale and composite scores all improved significantly, as did the SF-36 s . Change in BMI was the main factor impacting the WOMAC pain score. Conclusion: There was a higher frequency of multiple MSK complaints, including non-weight-bearing sites compared to historical controls, before surgery, which decreased significantly at most sites following weight loss and physical activity. These benefits may improve further, as weight loss may continue for up to 24 months. The benefits seen with weight loss indicate that prevention and treatment of obesity can improve MSK health and function.

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Section: Discussionsupporting

confidence: 90%

Musculoskeletal findings in obese subjects before and after weight loss following bariatric surgery

et al. 2006

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“…6,11,18,19 Contudo, o tempo de follow-up destes doentes é ainda relativamente curto (mínimo de 18 meses, máximo de 46 meses), sendo que seria fundamental manter o acompanhamento dos doentes de forma a analisar a evolução ao longo do tempo -existe inclusivamente um artigo que refere que a resolução da diabetes mellitus tipo 2 é três vezes mais frequente aos 10 anos comparativamente a métodos de intervenção não cirúrgicos.…”

Section: Discussionunclassified

“…A literatura demonstra que existe uma melhoria significativa no que concerne a esta patologia após a realização de cirurgia bariátrica. 6,11,18,19 A literatura apoia também a hipótese de que os indiví-duos obesos, nomeadamente os candidatos a cirurgia bariátrica, têm mais frequentemente patologia do foro psicológico/psiquiátrico relativamente a indivíduos não obesos; 20 a 60% dos doentes sofrem de doença psiquiátrica do eixo I, 20 sendo a depressão, a ansiedade e o binge eating disorder das patologias mais comuns. 8,12,16,21 Observa-se também uma associação entre fatores psicológicos e psicossociais, comportamento alimentar disfuncional e obesidade.…”

Section: 17unclassified

“…10 Noutros casos, verificaram-se melhorias em termos de patologia depressiva ou ansiosa, com melhores resultados para a depressão. 12,18,19,23 A diabetes mellitus tipo 2 e as perturbações do foro psicológico/psiquiátrico são problemas que ocorrem em simultâneo e que se poderão relacionar entre si, sendo importante compreender a sua evolução após realização de cirurgia bariátrica e a sua influência nos resultados da cirurgia. 12,24,25 Tem sido demonstrado que tanto o comportamento alimentar 14,22 como a depressão 9,13 no período pós--cirúrgico se associam a uma menor perda de peso.…”

Section: 17unclassified

“…12,18,19,23 Contudo, esta é uma área de conhecimento que necessita de maior investigação porque estes resultados não são consistentes entre os diferentes estudos.…”

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Diabetes Mellitus Tipo 2, Depressão e Alterações do Comportamento Alimentar em Doentes Submetidos a Cirurgia Bariátrica

Brandão¹,

Pinho

Arrojado³

et al. 2016

Acta Med Port

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Resultados: Verificou-se melhoria relativamente à variável dicotómica diabetes mellitus tipo 2 após a cirurgia (χ 2 (1) = 26,132, p < 0,001). Não ocorreu melhoria significativa em termos de patologia psiquiátrica quando a análise foi controlada para o tipo de cirurgia. Encontrámos uma associação significativa entre as variáveis em estudo no pós-cirúrgico e a perda de peso. Este modelo explica 27% da variação do peso após a cirurgia (R 2 = 0,265) e é significativo F (3,33) = 2,981, p = 0,038. Discussão: A diabetes mellitus tipo 2, patologia depressiva ou do comportamento alimentar mostraram estar relacionados com a perda de peso. Não ficou esclarecido em que sentido esta relação é estabelecida, nem a relação que estas variáveis metabólicas e psicológicas possam ter entre si ao longo do período pós cirurgia bariátrica. Conclusão: A diabetes mellitus tipo 2 evoluiu favoravelmente após a cirurgia. Diabetes mellitus tipo 2, depressão e patologia alimentar no período pós-cirúrgico associaram-se a menor perda de peso. As variáveis estudadas no período pré cirúrgico não contribuíram de forma significativa para a perda de peso. Palavras-chave: Cirurgia Bariátrica; Comportamento Alimentar; Depressão; Diabetes Mellitus Tipo 2; Obesidade Mórbida. ABSTRACTIntroduction: Obesity is associated with a great number of complications, including type 2 diabetes mellitus and psychiatric pathology. Bariatric surgery is the best solution to weight loss and improvement of complications in morbid obese patients. This study aims to analyze the evolution of type 2 diabetes mellitus and psychopathologic variables before and after bariatric surgery and assess the importance of different variables in weight loss. Material and Methods: This is a longitudinal study, which evaluates 75 patients before and after bariatric surgery (47 -LAGBlaparoscopic adjustable gastric band; 19 -RYGB -Roux-en-Y gastric bypass; 9 -sleeve) with a follow-up time between 18 and 46 months. A clinical interview and self report questionnaires were applied -Eating Disorder Examination questionnaire -EDE-Q and Beck Depression Inventory -BDI. Results:Results show an improvement in type 2 diabetes mellitus after surgery (χ 2 (1) = 26.132, p < 0.001). There was not a significant improvement among psychiatric pathology when we controlled the analysis for the type of surgery. It was verified that type 2 diabetes mellitus, depression and eating disorders in post-operative period are associated with less weight loss. This model explains 27% of weight variance after surgery (R 2 = 0.265) and it is significant F (3.33) = 2.981, p = 0.038. Discussion: Type 2 diabetes mellitus, psychiatric pathology and eating disorders after surgery influenced weight loss. It was not clear in what way this relation was verified, neither the relation that these metabolic and psychological variables may have during the postoperative period. Conclusion: Type 2 diabetes mellitus improved after surgery. Type 2 diabetes mellitus, depression and eating disorders influenced weight loss in the postoperativ...

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Association Between Bariatric Surgery and Long-term Health Care Expenditures Among Veterans With Severe Obesity

et al. 2019

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IMPORTANCE Bariatric surgery has been associated with improvements in health in patients with severe obesity; however, it is unclear whether these health benefits translate into lower health care expenditures. OBJECTIVE To examine 10-year health care expenditures in a large, multisite retrospective cohort study of veterans with severe obesity who did and did not undergo bariatric surgery. DESIGN, SETTING, AND PARTICIPANTS A total of 9954 veterans with severe obesity between January 1, 2000, and September 30, 2011, were identified from veterans affairs (VA) electronic health records. Of those, 2498 veterans who underwent bariatric surgery were allocated to the surgery cohort. Sequential stratification was used to match each patient in the surgery cohort with up to 3 patients who had not undergone bariatric surgery but were of the same sex, race/ethnicity, diabetes status, and VA regional network and were closest in age, body mass index (calculated as weight in kilograms divided by height in meters squared), and comorbidities. A total of 7456 patients were identified and allocated to the nonsurgery (control) cohort. The VA health care expenditures among the surgery and nonsurgery cohorts were estimated using regression models. Data were analyzed from July to August 2018 and in April 2019. INTERVENTIONS The bariatric surgical procedures (n = 2498) included in this study were Roux-en-Y gastric bypass (1842 [73.7%]), sleeve gastrectomy (381 [15.3%]), adjustable gastric banding (249 [10.0%]), and other procedures (26 [1.0%]). MAIN OUTCOMES AND MEASURES The study measured total, outpatient, inpatient, and outpatient pharmacy expenditures from 3 years before surgery to 10 years after surgery, excluding expenditures associated with the initial bariatric surgical procedure. RESULTS Among 9954 veterans with severe obesity, 7387 (74.2%) were men; the mean (SD) age was 52.3 (8.8) years for the surgery cohort and 52.5 (8.

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Health-related quality-of-life in patients with morbid obesity after gastric banding for surgically induced weight loss

Cited by 70 publications

References 41 publications

Musculoskeletal findings in obese subjects before and after weight loss following bariatric surgery

Musculoskeletal findings in obese subjects before and after weight loss following bariatric surgery

Diabetes Mellitus Tipo 2, Depressão e Alterações do Comportamento Alimentar em Doentes Submetidos a Cirurgia Bariátrica

Association Between Bariatric Surgery and Long-term Health Care Expenditures Among Veterans With Severe Obesity

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