Long-term Health-related Quality of Life Following Gastric Bypass: Influence of Depression

Background: Severe obesity has been associated with impaired quality of life (QoL). We evaluated the long-term health-related quality of life (HRQoL) after gastric bypass.

Methods: A cross-sectional study was conducted on 50 morbidly obese patients >5 years after gastric bypass and on a control group of 78 non-operated morbidly obese patients. Both groups were evaluated for the EuroQol 5D measure and the Goldberg General Health Questionnaire. In addition, the Bariatric Analysis of Reporting Outcome System (BAROS) was applied to the surgical group. Depression and severe life events were included in the analysis. Logistic Regression Model was used, and age was included in the analysis.

Results: Groups were similar except for mean age (lower in the surgical group: 40.5+/-9.0 vs 46.1+/-8.8 years, P=0.026). 86.5% of patients had >50% Excess Weight Loss. 85.7% showed an improvement in co-morbid conditions. BAROS Global score: 22% excellent, 56% very good, 18% good, 2% fair and 2% failure. After surgery, significant improvements were reported in self-esteem (94%), work conditions (72.6%), physical activity (66.7%), and sexual interest/activity (50.9%). The control group showed poorer results for the EuroQol 5D in mobility (55% vs 21.6%, P=0.005), difficulty with daily activity (55% vs 13.7%, P=0.005) and self-evaluation of well-being (59.2% vs 78.1%, P=0.005). Patients with depression or insufficient weight loss following surgery presented poorer global evaluation in HRQoL.

Conclusion: Gastric bypass resulted in significant long-term improvements in co-morbidities, sustained weight loss and increased HRQoL. Depression and insufficient weight loss were associated with poorer HRQoL in surgical patients.