Quality of life after bariatric surgery - Is there a difference?

Background: Interest in the quality of life (QoL) of patients with morbid obesity continues to grow. Weight loss has been shown to improve QoL in obese persons undergoing a variety of treatments, but there is little data available comparing different surgical procedures and QoL questionnaires. Methods: In 133 patients, four different questionnaires where applied: the SF-12v2 (short form of SF-36), the BAROS (Bariatric Analysis and Reporting Outcome System), the GIQLI (Gastrointestinal Quality of Life Index) and the BQL (Bariatric Quality of Life Score). These patients underwent laparoscopic gastric banding (LAGB; n = 55), laparoscopic Roux-en-Y gastric bypass (RYGB; n = 49), biliopancreatic diversion with duodenal switch (BDP-DS; n = 23), or vertical banded gastric bypass (VBGB). All these procedures where performed in one bariatric center in Germany. Results: In all groups, QoL scores and excess weight loss (EWL) improved considerably, but EWL was clearly higher in BPD-DS and RYGB patients (62 and 60%) as compared to LAGB cases (47%). Similarly, standardized 1-year BQL scores were better for BPD-DS and RYGB (76 and 80%) than for LAGB (71%). Furthermore, weight changes over time seemed to reach a plateau phase in the LAGB patients, whereas BPD-DS led to continuing weight loss. Discussion: Although all procedures are effective, our data show important differences between the different procedures. Since weight loss after LAGB is smaller and less progressive, smaller improvements in QoL can be expected although the risk of complications is less. This should be borne in mind when selecting the type of surgery.