Bariatric surgery and its impact on long-term (≥ 5 years) health related quality of life

Abstract

Bariatric surgery results in significant weight loss in the majority of patients living with severe obesity (BMI≥35kg/m²). Improvement in Health Related Quality of Life (HRQoL) is an equally important patient reported outcome; however, there are few studies reporting the impact of bariatric surgery on long-term (≥5 years) HRQoL outcomes. The main aim of this thesis was two-fold: first to conduct a SR in order to assess the quality of evidence and effectiveness of bariatric surgery on HRQoL ≥ 5 years in patients ≥18 years compared to non-surgical control groups and second to conduct a meta-analysis (MA) of studies that have been deemed appropriate. PubMed, Cochrane Review, EmBase, CINANL, PsycInfo, obesity conference abstracts, and reference lists of published papers were searched. Keywords were bariatric surgery, obesity, and quality of life. Studies were included if (1) there was ≥5 years follow-up, (2) patients had class II or III obesity, (3) individuals completed a validated HRQoL survey, and (4) there was a nonsurgical comparison group with obesity. Two reviewers independently assessed each study. From the initial 1376 articles, 9 studies were included in the SR and 6 in the MA. Inconsistent results for long-term improvements in physical and mental health emerged from the SR. However, in contrast, the MA found significant improvements in these domains ≥5 years after bariatric surgery. These study findings provide evidence for a substantial and significant improvement in physical and mental health favoring the surgical group compared with controls spanning 5 to 25 years after surgery, an important finding for patients, clinicians and decisionmakers.