Impact of bariatric surgery on health-related quality of life in people with obesity

There have been reports of varying results when examining the effect of health-related quality of life (HRQoL) following bariatric surgery in small studies.

The current observational study included United Kingdom National Bariatric Surgery Registry (NBSR) records between 1st June 2017 and 23rd November 2022. The inclusion criteria were the patients who underwent primary bariatric surgery and had at least one baseline assessment as well as one follow-up visit within one year of the surgery. Models evaluated the association between EuroQol Five Dimension 5-level (EQ-5D) and BMI at baseline and longitudinally. Additional studies were stratified by type 2 diabetes, type of operation (adjustable gastric band, sleeve, or bypass) and domain of EQ-5D.

The researchers investigated 5,587 observations of a total of 2,160 patients. The mean EQ-5D was 0.78±0.22 and the mean BMI was 45.7±7.8 kg/m2 at baseline. EQ-5D was found to be 0.005 (95%CI[−0.006,−0.004]) lower among those with a BMI higher by 1 kg/m2. One-month post-surgery, EQ-5D rose to 0.91±0.2 while BMI fell to 39.8±7.1 kg/m2. Eventually EQ-5D plateaued at 0.90±0.17 while BMI kept falling (31.5±6.2 kg/m2 at 12 months). The study showed that each 1 kg/m2 drop in BMI was linked with a 0.006 (95%CI [−0.007,−0.005]) rise in EQ-5D. An increase in EQ-5D (0.037, 95%CI [0.015,0.059]) was independently correlated with type 2 diabetes (T2D) remission. All five of the EQ-5D's domains improved, which was directly related to a decrease in BMI of the patient.

Thus, the study concluded that a greater reduction in weight and T2D remission were independently correlated with greater amelioration in HRQoL following bariatric surgery. The connection between HRQoL and BMI for patients receiving bariatric surgery is not the same as what has been estimated in the past due to the inclusion of behavioural interventions. It will be crucial to use the estimates produced here in clinical and political decision-making.

 Source: Buckell J, Small PK, Jebb SA, Aveyard P, Khan O, McGlone ER; NBSR Collaborators. What is the effect of bariatric surgery on health-related quality of life in people with obesity? observational cohort analysis of the United Kingdom national bariatric surgery registry. Int J Surg. 2024 Aug 22. doi: 10.1097/JS9.0000000000002044. Epub ahead of print. PMID: 39172711.