Health-Related Quality of Life in Bariatric and Metabolic Surgery
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HEALTH SERVICES AND PROGRAMS (R WELBOURN AND C BORG, SECTION EDITORS)
Health-Related Quality of Life in Bariatric and Metabolic Surgery Karen D. Coulman 1,2
&
Jane M. Blazeby 1,3,4
# The Author(s) 2020
Abstract Purpose of Review This review describes the latest evidence for the impact of bariatric surgery on health-related quality of life (HRQL). Recent Findings The impact of bariatric surgery on HRQL is less well-understood than its clinical effectiveness on weight and co-morbidities. Poor-quality study design and different HRQL measures challenge systematic reviews and meta-analyses. Available limited evidence suggests that physical aspects of HRQL may improve more than mental health aspects of HRQL after bariatric surgery, reaching maximal benefits 1–2 years post-surgery. Comparative HRQL analyses between bariatric procedures cannot be made due to a lack of randomised data. Qualitative research highlights the tensions patients experience after bariatric surgery, which provides insights to observed changes in HRQL. Summary Standardized HRQL measures are being developed and agreed to improve future evidence synthesis. Two multi-centre randomised trials of bariatric surgical procedures including detailed HRQL assessment are in progress. It is hoped that the combination of comparative high-quality HRQL data and information from qualitative studies will provide new insights into patient well-being and health after bariatric surgery. Keywords Bariatric surgery . Obesity . Health-related quality of life . Psychosocial outcomes
Introduction Over 650 million or 13% of adults worldwide are living with obesity (body mass index (BMI) ≥ 30 kg/m2), representing a tripling of figures since 1975 [1]. Obesity is associated with an increased risk of type 2 diabetes, cardiovascular disease, certain cancers, depression, reduced quality of life and premature death
This article is part of the Topical Collection on Health Services and Programs * Karen D. Coulman [email protected] 1
Population Health Sciences, Bristol Medical School, University of Bristol, 1-5 Whiteladies Road, Bristol BS8 1NU, UK
2
Obesity and Bariatric Surgery Service, North Bristol NHS Trust, Bristol, UK
3
Division of Surgery, Head and Neck, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
4
National Institute for Health Research Bristol Biomedical Research Centre Surgical Innovation Theme, Bristol Centre for Surgical Research, Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, UK
[2–7]. Effective public health initiatives are critically important to prevent future obesity; however, experts agree these are not sufficient to achieve weight loss in those already living with obesity, particularly those with severe and complex obesity (BMI of ≥ 40 kg/m2, or 35–40 kg/m2 with another significant health problem that could be improved by weight loss), who are at the highest risk of morbidity and premature death [8–10]. In 2018, 3% of adults in England were reported to have a BMI ≥ 40 kg/m2, and data fro
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