Sleeve gastrectomy, gastric bypass associated with similar quality of life improvements
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Adults with obesity who underwent bariatric surgery at a clinic in Turkey had similar improvements in quality of life, regardless whether they underwent a sleeve gastrectomy or Roux-en-Y gastric bypass, according to study data.
“Bariatric surgery will continue to be at the forefront in the fight against obesity until such time as an alternative nonsurgical method can be developed,” Emre Turgut, MD, of the department of gastrointestinal surgery, faculty of medicine at the University of Inonu in Malatya, Turkey, and colleagues wrote in a study published in Bariatric Surgical Practice and Patient Care. “There seem to be no important differences in the patients’ quality of life, whichever technique is chosen. Both laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass led to a similar and substantial increase in life quality for all patients.”
Researchers conducted a cross-sectional study of 316 adults who underwent bariatric surgery at Inonu University School of Medicine from December 2018 to December 2019 (79% women; median age, 36 years). Participants were divided into three groups: those who had a preoperative checkup (n = 86), those who underwent a sleeve gastrectomy (n = 86) and those who had Roux-en-Y gastric bypass (n = 148). Participants completed the SF-36 to measure self-reported physical and mental health and the Obesity-related Problems Scale to measure the effect of obesity on human psychosocial function. Both questionnaires were conducted during follow-up appointments at approximately 3 months, 6 months and 1 year after surgery.
There was no significant difference in amount of weight loss or in the SF-36 results between the two surgery groups. Participants in both surgery groups had a significant improvement in quality of life, with men reporting a better overall quality of life after surgery than women (P = .002). Quality of life was the highest 6 months after surgery before declining slightly at 12 months (P < .05).
“This decrease could be because of a slowdown in weight loss after the first 6 months, and a dip in motivation caused by the stringent limitations of the postoperative care needed after the procedure chosen,” the researchers wrote. “These limitations include a strict diet and nutritional supplements that the patients need to take regularly.”
In subgroup analysis, people younger than 50 years reported better physical functioning (P = .006), fewer physical limitations (P = .036) and lower pain levels (P = .042) after surgery compared with adults aged 50 years and older. People with a higher BMI had a longer hospital stay (P = .003) and lower scores for physical functioning (P < .001), physical limitations (P < .001), emotional limitations (P = .002), energy (P < .001), social functioning (P < .001), pain (P = .001), general health perception (P = .001) and quality of life (P < .001).
“As an increase in both age and BMI levels has a negative impact on physical results in particular, it seems that we should avoid taking a uniform approach to the treatment of all patients with a BMI of 40 kg/m2 or above,” the researchers wrote. “In this patient group, it may be more beneficial to attempt to increase physical function and reduce BMI levels, before admitting the patient for surgery.”
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