A. J. Vegel1, N. Shah1, A. O. Lidor1, J. A. Greenberg1, Y. Shan1, X. Wang1, L. M. Funk1 1University Of Wisconsin-Madison,Department Of Surgery,Madison, WI, USA
Introduction: Bariatric surgery is the most effective method for weight loss and comorbidity resolution among patients with severe obesity. However, there are limited data describing its impact on patient-reported quality of life (QoL). We sought to determine the impact of bariatric surgery on patient-reported QoL and identify variables associated with higher postoperative QoL.
Methods: QoL data were collected from patients (n=209) who underwent bariatric surgery at a single institution from January 2010 through December 2012. QoL scores were obtained by administering the Moorehead-Ardelt Quality of Life Questionnaire II (MAQoLII) during clinical visits. The MAQoLII is a validated survey addressing self-esteem, physical activity, social life, work ability, sexual functioning and approach to food. Cumulative scores can range from +3.0 (“Very Good”) to -3.0 (“Very Poor”). Patient demographics, preoperative comorbidities and weight loss data were collected from a retrospective bariatric surgery database. A repeated measures ANOVA test was used to analyze the trend in QoL scores at the preoperative visit and consecutive postoperative visits. Multivariable logistic regression was used to generate odds ratios for variables hypothesized a priori to be associated with higher QoL postoperatively. A non-responder analysis was performed to identify potential sources of selection bias.
Results: Patients lost an average of 59.1% (±19.0) of their excess body weight one year after surgery. Mean body mass index(BMI) decreased by 13.3 kg/m2 (±12.4). 87 patients (41.6%) responded to the MAQoLII at one year. Mean QoL scores doubled from 0.82 preoperatively to 1.66 one year postoperatively (p<0.001) (Figure). Patients scored higher in all individual areas of the MAQoLII one year after surgery: self-esteem (0.36 vs. 0.22; p=0.008), physical activity (0.31 vs. 0.11; p=0.003), social life (0.36 vs. 0.28; p=0.048), work ability (0.22 vs. 0.07; p<0.001), sexual functioning (0.16 vs. 0.04; p=0.019) and approach to food (0.26 vs. 0.11; p=0.004). On multivariable analysis, higher QoL was associated with private insurance/self-pay vs. Medicare (OR 3.87 [95% CI 1.36–11.0]). There was no association between QoL and gender, race, preoperative BMI and comorbidities or excess weight loss. The non-responder analysis indicated that survey responders were older (49.4 vs. 45.3; p=0.017) and more likely to be Caucasian (93.2% vs. 83.5%; p=0.036).
Conclusion: Bariatric surgery patients experienced significant improvements in quality of life one-year post surgery. Modifiable predictors of a high quality of life after bariatric surgery remain unclear and will require additional investigation.
