Physical and psychosocial outcome in morbidly obese patients with and without bariatric surgery:: a 4 1/2-year follow-up

Background: Morbidly obese patients show high somatic and psychiatric co-morbidity. Bariatric surgery is accepted as the obesity treatment with the greatest long-term success. There is growing evidence that follow-up studies should address somatic as well as psychosocial conditions of patients undergoing bariatric surgery and non-operatively treated patients. This study investigates the physical and psychosocial outcomes of patients with and without bariatric surgery. Methods: A sample of 131 morbidly obese patients applying for bariatric surgery underwent somatic and psychological assessment (TO). A first follow-up study (T-0) was conducted 2 years after T-0 in 119 patients. The present second follow-up (T-1) was carried out 41/2 years after T-0 and 3.2 years after potential bariatric surgery. Psychologicallpsychosocial measures were collected in the 93 patients, 63 of whom were treated surgically, via the Psychosocial Stress and Symptom Questionnaire (PSSQ) and a telephone interview covering BMI, employability, medication, doctor consultations, eating behavior, and physicalipsychological well-being. Results: Patients with and without bariatric surgery showed a BMI reduction, which was significantly greater in those who underwent surgery (P <.001). The average percentage of excess weight loss (%EWL) between T-0 and T-2 was 11.5% in patients with no bariatric surgery, 36.0% in patients with laparoscopic gastric banding, T-0 and T-2 in patients of all groups significant, P <.001). Patients with and without surgical treatment showed significant improvement with regard to depressive symptoms and binge-eating behavior. Three-quarters of the surgically-treated and two-thirds of the non-treated patients rated their physical, psychological, and psychosocial welkbeing as "good" at T-2. Conclusion: After 3 to 4 years, all of the patients have adapted well to their weight and body appearance, regardless of whether they have undergone surgery. Weight loss is, however, greater for operated patients, which strongly decreases the risk of developing obesity-related co-morbidities.