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Quality of Life After Gastric Bypass

QoL After Biliopancreatic Diversion

Obesity Surgery Advice - Research Into Obesity Surgery

Quality of Life in Obese Patients After Biliopancreatic Diversion Stomach Bypass (BPD)

This research study examined health-related quality of life in morbidly obese subjects before and after biliopancreatic diversion (BPD). Quality of life (QoL) was assessed by using the Impact of Weight on Quality of Life (IWQOL) questionnaire, which was administered to (1) 50 obese patients prior to and 1 year after biliopancreatic diversion; (2) 150 post-obese subjects 3 years after biliopancreatic diversion; and (3) 50 lean patients (control). Twelve months after the bypass operation, the study disclosed a sharp improvement toward normality in the QoL, and other data suggests that this result was maintained long term. Bottom line: after biliopancreatic diversion bypass, patients' weight loss and long-term maintenance are accompanied by a range of beneficial effects on their QoL.

Impact of Obesity on Quality of Life

Obesity significantly restricts physical functioning in a patient's everyday life because of the extreme excess weight he or she carries; also, because of health complications, obesity greatly affects a person's medical status, leading (eg) to significant increased risk of cardiovascular disease and reduction in life expectancy. Furthermore, obesity is typically aggravated by psychological problems that link up with lack of social understanding towards obese persons. Thus, severely obese patients rarely have the capacity to live as fully and actively as they would like, and thus experience an overall impaired quality of life.

Quality of Life After Biliopancreatic Diverson Surgery

Compared with dieting and exercise treatments, during which a complete recovery from obesity is very rarely observed, bariatric surgical operations (when accompanied by increased physical activity, a self-selected calorie-controlled diet, and group support) offer sustainable weight loss with improved health conditions plus an increase of both physiological and psychological well-being. However, different bariatric procedures may give rise to different effects that influence the quality of life following weight loss.

Operation Used: Distal Gastrectomy With Roux-en-Y

The study assessed the effect of biliopancreatic diversion on QoL. This operation involves a distal gastrectomy and a Roux-en-Y reconstruction, with a 50 cm common channel. This arrangement of gastrointestinal transit determines maldigestion and then malabsorption of fat and starch for delayed mixing between alimentary substrates, bile, and pancreatic juice, which provokes and maintains weight loss.

Impact of Weight on Quality of Life (IWQOL) Questionnaire

The IWQOL is commonly used as a treatment outcome measure to assess the effect of weight on quality of life in 8 key areas: ( 1 ) general and perceived health, (2) interpersonal relationships, (3) mobility, (4) capacity of work, (5) self-esteem, (6) activity of daily living, (7) sexual life, and (8) comfort with food. On the IWQOL, higher scores indicate poorer quality of life.

Study Participants

The longitudinal group of the study comprised 50 subjects (19 males) aged from 20 to 55 years (M = 36), who underwent biliopancreatic diversion to reduce obesity at the Dept of Surgery (University of Genoa), from January to December 2001. The patients had this gastric bypass because of their repeated failed attempts to lose weight with conventional diets. The IWQOL questionnaire was given to the patients just before their biliopancreatic diversion operation and 1 year afterwards in conjunction with their regular post-operative visit.

Results of QoL Study

  • The study disclosed a sharp reduction in mean body weight and body mass index values at the time of the 1-year follow-up visit. Also, there was a significant improvement in both physical and mental quality of life areas. However, patient "comfort with food" remained largely unchanged in comparison with the preoperative data.
  • Results for patients assessed 3 years after their biliopancreatic diversion surgery which covered mental well-being, (interpersonal relationships, self-esteem, and sexual life subscales) were substantially similar to those observed in both healthy controls and in individuals at 1 year after biliopancreatic diversion, whereas general and perceived health scores were higher in comparison with the data obtained in healthy subjects and in individuals at shorter term following the operation. For the scores of other IWQOL subscales exploring the physical domain of QoL (ie, mobility, capacity of work, and activity of daily living subscales), the findings were essentially similar to those observed in the other groups of subjects.

The study's main finding is that weight loss in obese patients having undergone distal biliopancreatic stomach bypass was accompanied by a significant improvement in the quality of life in all the areas explored. In fact, by one year after the operation the results were similar to those recorded in healthy control subjects. Even so, longer term studies of patients after bariatric bypass are still needed to confirm these clinical results.

Source:
Gian Franco Adami, MD; Giovanni Ramberti, MD; Annalisa Weiss, MD; Flavia Carlini, MD; Federica Murelli, MD; Nicole Scopinaro, MD. Drs Adami, Ramberti, Weiss, Carlini, Murelli, and Scopinaro are with the Dipartimento di Discipline Chimrgiche, Facolt di Medicina e Chirurgia, Universit di Geneva, Genoa, Italy.

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Laparoscopic or open bariatric surgery, such as gastric banding or bypass is not an easy solution to morbid obesity and weight loss. It is a serious surgical procedure, involving health risks. To produce lasting weight loss it requires a long-term patient commitment to eating a healthy diet and following a regular program of physical exercise. Life-long use of nutritional supplements may also be necessary. So, before deciding, discuss your options fully with your doctor. © 2003-2017 Bariatric-Surgery.Info - Terms - Contact - Information - Resources