Improvement of Health-Related Quality of Life After Roux-en-Y Gastric Bypass Related to Weight Loss

Abstract

IntroductionEffect of bariatric surgery on health-related quality of life (HRQOL) varies greatly. This might be caused by the diversity in questionnaires used to assess HRQOL and the weight loss of the studied population. This study assesses the relationship between weight loss and HRQOL in primary Roux-en-Y gastric bypass (RYGB) patients by using an obesity-specific (impact of weight on quality of life-lite, IWQOL-lite) and a generic (RAND-36) questionnaire.MethodsHRQOL and weight parameters were assessed before and 15 and 24 months after RYGB surgery. HRQOL was assessed by using IWQOL-lite (an obesity-specific questionnaire consisting of one total score and five domains) and RAND-36 (a generic questionnaire consisting of two subtotal scores, the physical health summary (PHS) and mental health summary (MHS), and nine scales).ResultsTwo thousand one hundred thirty-seven patients were included. HRQOL improved significantly after RYGB. Preoperative BMI was negatively related to baseline PHS (p < 0.001) and IWQOL-lite total (p < 0.001). Percentage total weight loss (%TWL) was positively related to HRQOL score at both follow-up moments. Change in HRQOL from baseline to 24 months was related to %TWL at 24 months in both subtotals of RAND-36 and IWQOL-lite total score (p ≤ 0.001 in all).ConclusionHRQOL improves after RYGB. Higher %TWL is related to greater improvement in HRQOL and better HRQOL 15 and 24 months after RYGB. The variance in the effect of RYGB surgery on HRQOL can be explained by the questionnaire used and weight loss of the population.

Meeting physical activity recommendations is associated with health-related quality of life in women before and after Roux-en-Y gastric bypass surgery

“…All intensity levels of PA were higher 12-month post-surgery compared to pre-surgery, although not statistically significant, except for step counts. Great improvements in HRQoL after bariatric surgery, in line with our results, have been seen in several previous studies [ 12 , 13 , 23 ], with a peak improvement at 12-month post-surgery [ 33 ]. Contrary to previous studies on objectively measured PA after bariatric surgery [ 34 , 35 ], participants in the current study increased both MVPA and LPA at 12-month post-surgery.…”

“…Individuals suffering from obesity often show lower levels of HRQoL compared to the general normal weight population [ 10 ]. Weight loss has been associated with increases in HRQoL [ 11 ], especially rapid weight loss induced by bariatric surgery [ 12 – 14 ], where Roux-en-Y gastric bypass (RYGB) is the most commonly performed bariatric surgery procedure in Sweden [ 15 ]. Greatest improvements of HRQoL, induced by weight loss, are often seen on the physical part of the measurement scale, probably caused by the reduced physical complaints after losing weight, but the mental part has also been shown to improve [ 12 , 13 ].…”

Definitions of Long-Term Weight Regain and Their Associations with Clinical Outcomes

“…Three definitions of weight regain (regain > 10 kg, regain 5 BMI, and regain EWL 25) were related to the physical health component of the RAND-36, measuring HRQoL. Several studies have shown that HRQoL improves after bariatric surgery and that this improvement is related to the amount of weight lost [3, Table 5 Linear regression investigating the effect of weight regain, according to different definitions, on HRQoL [37][38][39]. They also show stronger associations with the physical health component than the mental health component [38,40].…”

Effects of Cognitive Behavioral Therapy on Eating Behaviors, Affective Symptoms, and Weight Loss After Bariatric Surgery: a Randomized Clinical Trial

“…The short form of impact of weight on quality of life (IWQOL-lite) is a 31-item questionnaire which assesses the impact of weight on quality of life with acceptable validity and reliability in patients with obesity (test-rest reliability r = 0.74–0.91; α = .85). It contains the five domains, i.e., physical function, self-esteem, sexual life, public distress, and work [ 31 , 32 ]. An overall score was used, as a principal component analysis extracted a single component with an eigenvalue > 1 ( λ = 3.21, R 2 = 64%).…”