Quality of life after Roux-en-Y gastric bypass and changes in body mass index and obesity-related comorbidities

Aim. Dynamics of improvement in health-related quality of life (QoL) after bariatric surgery have never been fully assessed, and neither has the potential influence of body mass index (BMI) and comorbidity modification. The objective of this study was to investigate early and medium-term changes in QoL following Roux-en-Y gastric bypass (RYGB), and their relationship to BMI and comorbidity variations. Methods. A total of 71 obese subjects (80% women, mean age 42.1 +/- 11.2 years, mean baseline BMI 47.6 +/- 6.2 kg/m(2)) undergoing RYGB filled in QoL questionnaires (SF-36) before and 3, 6 and 12 months after surgery. QoL was assessed using repeated-measures Anova, with associations between its changes and changes in BMI and comorbidities (diabetes, hypertension, dyslipidaemia, sleep apnoea, knee pain) assessed by mixed-effects models. Results. Physical QoL scales (physical component summary, PCS) significantly increased over time (from 38.9 +/- 9.3 to 52.6 +/- 7.9; P < 0.001). as did other physical SF-36 scales (all P < 0.001), whereas mental QoL summary scale did not vary significantly (from 45.7 +/- 9.5 to 48.6 +/- 11.5; P = 0.072). Major changes in QoL occurred at 3 months after surgical intervention to reach values comparable to those in the general population. PCS was mostly associated with changes in either BMI or comorbidity status except for diabetes, dyslipidaemia and sleep apnoea. Conclusion. Results show that improvements in physical QoL after RYGB are observed as early as 3 months after intervention, and are independently associated with weight loss and improvements in comorbidities. (C) 2013 Published by Elsevier Masson SAS.