Beyond weight loss after sleeve gastrectomy: improvement in health-related quality of life

Objectives: Obesity and related diseases are increasing and with the bariatric procedures both the excess weightand the prevalence of these related diseases are decreasing. Both obesity and related diseases lead to impairmenton health-related quality of life of the patients. We aimed to evaluate the short-term effects of sleeve gastrectomyoperation on health related quality of life in patients that were operated for morbid obesity.Methods: Prospectively 62 patients that had sleeve gastrectomy operation enrolled in the study. The percentageof excess weight loss (%EWL) and the percentage of excess BMI loss (%EBMIL) were calculated 6 monthsafter the operation. Anthropometric data and obesity-related co-morbidities were recorded. SF-36 questionnairewas used in order to evaluate the general health quality of the patients.Results: The mean age of the patients was 37 years and the majority of the patients were female (74.2%). Atthe postoperative 6th month, mean %EWL was calculated as 52.7% and mean %EBMIL was 60.1%. Six monthsafter the operation, with the significant weight loss achieved, obesity-related co-morbidities were improved.Short Form-36 subscale scores at 6 months following the operation were observed, when compared with thepreoperative scores (all p < 0.001). The mean physical health score significantly improved from 46.1 to 83.6and the median mental health improved from 52 to 84, just 6 months after the sleeve gastrectomy operation.In multiple regression analysis %EWL was found to be a significant determinant of ∆ Mental health (Bcoefficient 0.490, p = 0.025) and ∆ Physical health (B coefficient 0.388, p = 0.047) after adjusting for gender,age, smoking, obstructive sleep apnea syndrome, hypertension, diabetes mellitus and coronary disease.Conclusions: With the successive weight loss after sleeve gastrectomy, at the postoperative 6th month, thephysical and mental health-related quality of life was significantly improved. Early and expedited regain ofthis quality of life after the operation is important for the patients and their social surroundings. Moreover it isimportant for the countries to decrease the medical expenses and increase labour productivity.

PDF

___

[1] Statistics NCfH. Health, United States, 2014: with special feature on adults aged 55-64. 2015.
[2] Erem C. Prevalence of overweight and obesity in Turkey. IJC Metab Endocr 2015;8:38-41.
[3] Organization WH. World health statistics 2016: monitoring health for the SDGs sustainable development goals: World Health Organization; 2016.
[4] Simonson DC, Halperin F, Foster K, Vernon A, Goldfine AB. Clinical and Patient-Centered Outcomes in Obese Patients With Type 2 Diabetes 3 Years After Randomization to Roux-en-Y Gastric Bypass Surgery Versus Intensive Lifestyle Management: The SLIMM-T2D Study. Diabetes Care. 2018;41:670-9.
[5] Monteiro F, Ponce DA, Silva H, Pitta F, Carrilho AJ. Physical function, quality of life, and energy expenditure during activities of daily living in obese, post-bariatric surgery, and healthy subjects. Obes Surg 2017;27:2138-44.
[6] Busetto L, Mozzi E, Schettino AM, Furbetta F, Giardiello C, Micheletto G, et al. Three years durability of the improvements in healthrelated quality of life observed after gastric banding. Surg Obes Relat Dis 2015;11:110-7.
[7] Pinar R. Reliability and construct validity of the SF-36 in Turkish cancer patients. Qual Life Res 2005;14:259-64.
[8] Demiral Y, Ergor G, Unal B, Semin S, Akvardar Y, Kıvırcık B, et al. Normative data and discriminative properties of short form 36 (SF-36) in Turkish urban population. BMC Public Health 2006;6:247.
[9] Kasapoğlu Aksoy M, Altan L, Güner A. The effectiveness of soft and semi-rigid cervical collars on acute cervical radiculopathy. Eur Res J 2018;4:16-25.
[10] Fezzi M, Kolotkin RL, Nedelcu M, Jaussent A, Schaub R, Chauvet MA, et al. Improvement in quality of life after laparoscopic sleeve gastrectomy. Obes Surg 2011;21:1161-7.
[11] Major P, Matłok M, Pędziwiatr M, Migaczewski M, Budzyński P, Stanek M, et al. Quality of life after bariatric surgery. Obes Surg 2015;25:1703-10.
[12] Height M, Tables W. Metropolitan life foundation. Stat Bull 1983;64:2-9.
[13] Ware Jr JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36): I. Conceptual framework and item selection. Med Care 1992,30:473-83.
[14] Gagner M, Hutchinson C, Rosenthal R. Fifth International Consensus Conference: current status of sleeve gastrectomy. Surg Obes Relat Dis 2016;12:750-6.
[15] Nocca D, Krawczykowsky D, Bomans B, Noël P, Picot M, Blanc P, et al. A prospective multicenter study of 163 sleeve gastrectomies: results at 1 and 2 years. Obes Surg 2008;18:560-5.
[16] Nikolić M, Kruljac I, Kirigin L, Mirošević G, Ljubičić N, Nikolić BP, et al. Initial weight loss after restrictive bariatric procedures may predict mid-term weight maintenance: results from a 12-month pilot trial. Bariatr Surg Pract Patient Care 2015;10:68-73.
[17] Zeller MH, Inge TH, Modi AC, Jenkins TM, Michalsky MP, Helmrath M, et al. Severe obesity and comorbid condition impact on the weight-related quality of life of the adolescent patient. J Pediatr 2015;166:651-9.e4.
[18] Dillon C, Peddle J, Twells L, Lester K, Midodzi W, Manning K, et al. Rapid reduction in use of antidiabetic medication after laparoscopic sleeve gastrectomy: The Newfoundland and Labrador Bariatric Surgery Cohort (BaSCo) Study. Can J Hosp Pharm 2015;68:113.
[19] Bobowicz M, Lehmann A, Orlowski M, Lech P, Michalik M. Preliminary outcomes 1 year after laparoscopic sleeve gastrectomy based on Bariatric Analysis and Reporting Outcome System (BAROS). Obes Surg 2011;21:1843-8.
[20] Ryan KK, Tremaroli V, Clemmensen C, Kovatcheva-Datchary P, Myronovych A, Karns R, et al. FXR is a molecular target for the effects of vertical sleeve gastrectomy. Nature 2014;509:183-8.
[21] Jia H, Zack MM, Thompson WW, Dube SR. Quality-adjusted life expectancy (QALE) loss due to smoking in the United States. Qual Life Res 2013;22:27-35.
[22] Charalampakis V, Bertsias G, Lamprou V, de Bree E, Romanos J, Melissas J. Quality of life before and after laparoscopic sleeve gastrectomy. A prospective cohort study. Surg Obes Relat Dis 2015;11:70-6.
[23] Raaijmakers L, Pouwels S, Thomassen S, Nienhuijs S. Quality of life and bariatric surgery: a systematic review of short-and long-term results and comparison with community norms. Eur J Clin Nutr 2017;71:441-9.