Two-year changes in generic and obesity-specific quality of life after gastric bypass Bariatric Surgery May Improve Employment Status in Unemployed, Underserved, Severely Obese Patients Evaluation of Health Status and Quality of Life after Bariatric Surgery: Comparison of Standard Roux-en-Y Gastric Bypass, Vertical Banded Gastroplasty and Laparoscopic Adjustable Silicone Gastric Banding Health-related quality of life after the surgical treatment of obesity. Health‐related quality of life after gastric banding Impact of Body Mass Index on Perioperative Outcomes in Patients Undergoing Major Intra-abdominal Cancer Surgery Psychological outcomes and predictors of initial weight loss outcomes among severely obese adolescents receiving laparoscopic adjustable gastric banding. Effects of a Multidisciplinary Lifestyle Intervention for Obesity on Mental and Physical Components of Quality of Life: The Mediatory Role of Depression Lifestyle intervention favorably affects weight loss and maintenance following obesity surgery. Influence of Reoperations on Long-Term Quality of Life After Restrictive Procedures: A Prospective Study Quality-of-Life Assessment of Morbidly Obese Patients who have Undergone a Lap-Band® Operation: 2-Year Follow-Up Study: Is the MOS SF-36 a useful instrument to measure quality of life in morbidly obese patients? Comprehensive behavioral-motivational nutrition education improves depressive symptoms following bariatric surgery: a randomized, controlled trial of obese Hispanic Americans. A pilot study investigating the efficacy of postoperative dietary counseling to improve outcomes after bariatric surgery. Evaluation of Gastric Bypass Patients 1 Year After Surgery: Changes in Quality of Life and Obesity-Related Conditions Quality of life before and after laparoscopic sleeve gastrectomy. A prospective cohort study. National Surgical Quality Improvement Program analysis of bariatric operations: modifiable risk factors contribute to bariatric surgical adverse outcomes. Is obesity a predictor of mortality, morbidity and readmission after cardiac surgery?
The study objectives were to assess 2-year changes in health-related quality of life ( HRQL ) after gastric bypass in patients with severe obesity and to analyze HRQL improvements in relation to weight loss after bariatric surgery . This was a prospect i ve intervention study with consecutive patients referred to two bariatric surgical units in the Basque Country . We used both generic ( Short Form Health Survey , SF-36 and EuroQol , EQ-5D ) , and specific question naires ( Moorehead-Ardelt , MA II and Obesity-related Problems Scale , OP ) . Effect sizes and receiver operating characteristic ( ROC ) curves were calculated to assess the change in quality of life . Spearman ’s correlation coefficient was calculated to assess whether there was an association between changes in body mass index ( BMI ) and HRQL . Of 82 patients who underwent surgery , 79 were followed-up for 2 years . Mean weight loss was 37 % of body weight ( 49 kg ) and BMI fell from 50.6 to 31.8 . The initial problems and final improvements were greater in the physical dimensions . Considerable benefits were observed in assessment s with all the instruments used . However , the changes in weight/ BMI and HRQL were not linear . The comparison with general population showed a similar profile in SF-36 dimensions after surgery . Severely obese patients have lower perceived health across all dimensions of quality of life . Moreover , the impact on functioning is so important that severe obesity can be described as a cause of disability that disappears 2 years after surgical treatment . ROC curves indicate that most of the HRQL measures are poor predictors of change in terms of reduction in body weight or BMI Background The purpose of this study was to determine the impact of bariatric surgery on employment status in underserved , unemployed patients with severe obesity . Methods A retrospective review of all unemployed severely obese patients seen in our urban safety-net bariatric surgery program was performed . Preoperative patient question naires and medical records were review ed to evaluate patient employment status at the time of initial evaluation by the multidisciplinary bariatric surgery team . Follow-up data was obtained on all available patients ( including those who did not undergo surgery ) , including weight and employment status . A st and ardized telephone question naire was administered to supplement details regarding employment . Changes in employment status and body weight were determined in both groups . Results Here , 193 unemployed severely obese patients were evaluated by the multidisciplinary obesity team . The vast majority of patients ( > 80 % ) were minorities ( primarily Hispanic ) and publicly insured . Seventy-two underwent bariatric surgery and 121 did not . Twenty-four percent of the surgical patients and 9 % of the non-surgical patients had acquired full-time employment at least one year postoperatively ( p = 0.043 ) . There was a 10-point body mass index reduction in the surgical group , compared to 1-point reduction in the non-surgical group after one year . Conclusions Bariatric surgery may improve employment status in an unemployed severely obese patient cohort . Future research in this area should collect detailed prospect i ve data on employment prior to surgery and assess changes longitudinally to provide a more complete picture of the impact of bariatric surgery on employment Background : This study is a trial to compare the effects and outcomes of three different  bariatric procedures performed in two centers .  St and ard Roux-en-Y gastric bypass was performed by Dr. Norman Samuels in Fort Lauderdale ( Florida ) ; vertical b and ed gastroplasty and laparoscopic adjustable silicone gastric b and ing were done in Hallein ( Salzburg ) by Dr. Emanuel Hell and Dr. Karl Miller . Methods : In a prospect i ve comparative study 30 matched patients from each group were followed to assess post-operative improvement in health status and quality of life , to compare the three different techniques . The  Bariatric Analysis and Reporting Outcome System ( BAROS  ) as described by Oria and Moorehead has been used for evaluation . Results : The observation time was at least 3 years ( 3 to 8 years ) in each individual case . A significant increase in quality of life and health status in 75 % of the surgically-treated patients was observed when compared with a non-operated control group of morbidly obese patients . Conclusions : By utilizing BAROS it has been found possible to compare the results of different procedures done by different surgeons with different techniques , utilizing patients from different cultures and with different language s. The results of this comparative study favor the st and ard gastric bypass for the treatment of morbid obesity . This operation is superior to purely gastric restrictive procedures in weight loss and improvement of quality of life The aim of the study is to answer the question : what is the range and character of changes within health-related quality of life ( HRQL ) in obese patients who have undergone surgical treatment ( VBG - vertical b and ed gastroplasty or RYGBP - Roux-en-Y gastric bypass )  in the period of three and six months after operation ? Three groups of patients participated in the study : G I ( n=33 ; BMI 49.90 + /- 6.74 kg/m(2 ) ) - tested prior to the operation , G II ( n=17 ; BMI 34.26 + /- 5.28 kg/m(2 ) ) - tested six months after the operation , and G III ( n=11 ) - examined prior to the operation ( BMI 45.72 + /- 5.27 kg/m(2 ) ) as well as three months after the operation ( BMI 36.10 + /- 4.60 kg/m(2 ) ) . The Nottingham Health Profile ( NHP ) question naire was used as an indicator of HRQL . Surgical treatment of obesity result ed in significant positive changes in relation to the basic dimensions of NHP : energy , pain , physical mobility and in the influence of the current health state on selected spheres of life : paid employment , jobs around the house , social life , sex life , interests and hobbies , holidays . Significant changes in HRQL result ing from bariatric surgery occur in a relatively short period of time and are related not only to physical but also to social functioning Bariatric surgery ameliorates  obesity‐associated diseases  , result ing in psychological and social benefits . Long‐term studies of its effects on quality of life ( QOL ) assessed with well established instruments are lacking . This prospect i ve study investigated the long‐term effects of  gastric b and ing  on health‐related QOL using an obesity‐specific vali date d measure Background Obesity is an increasingly common serious chronic health condition . We sought to determine the impact of body mass index ( BMI ) on perioperative outcomes in patients undergoing major intra-abdominal cancer surgery .  Methods A prospect i ve , multi-institutional , risk-adjusted cohort study of patients undergoing major intra-abdominal cancer surgery was performed from the 14 university hospitals participating in the Patient Safety in Surgery Study of the National Surgical Quality Improvement Program ( NSQIP ) . Demographic , clinical , and intraoperative variables and 30-day morbidity and mortality were prospect ively collected in st and ardized fashion . Analysis of variance , Bonferroni multiple comparisons of means tests , and multivariable logistic regression analysis were performed . Results We identified 2258 patients who underwent esophagectomy ( n = 29 ) , gastrectomy ( n = 223 ) , hepatectomy ( n = 554 ) , pancreatectomy ( n = 699 ) , or low anterior resection/proctectomy ( n = 753 ) . Patients were stratified by National Institutes of Health (NIH)-defined BMI obesity class , with 573 ( 25.4 % ) patients classified as obese ( BMI > 30 kg/m2 ) . There were no differences in mean work relative value units , total time of operation , or length of stay amongst the BMI classes . After adjusting for other risk factors , obesity was not a risk factor for death or major complications but was a risk factor for wound complications . The risk of postoperative death was greatest in underweight patients ( odds ratio [ OR ] 5.24 ; 95 % confidence interval [ CI ] 1.7–16.2 ) . Conclusion In patients undergoing major intra-abdominal cancer surgery , obesity is not a risk factor for postoperative mortality or major complications . Importantly , underweight patients have a fivefold increased risk of postoperative mortality , perhaps a consequence of their underlying nutritional status OBJECTIVE Elevated rates of psychopathology are noted among severely obese youth presenting for weight loss surgery . The role of mental health providers in this population is not well defined , and the selection of c and i date s is often the result of clinical judgment alone . The purpose of this study was to comprehensively evaluate psychiatric symptoms among a large sample of adolescents receiving laparoscopic adjustable gastric b and ing ( LAGB )  by ( 1 ) examining changes in depressive symptoms and quality of life in the year following surgery ; ( 2 ) evaluating the interaction between patterns of change in depression , quality of life , and weight postsurgery ; and ( 3 ) identifying presurgical psychological predictors of initial weight change . METHOD Participants were 101 severely obese adolescents aged 14 to 18 years receiving LAGB at the Center for Adolescent Bariatric Surgery at the Morgan Stanley Children 's Hospital of New York Presbyterian/Columbia University Medical Center between August 2006 and December 2009 . Measures of height , weight , depressive symptoms , and quality of life were obtained in the first year following surgery . Changes in the Beck Depression Inventory ( BDI ) , Pediatric Quality of Life Inventory ( PedsQL ) , and body mass index were analyzed using latent growth curve modeling . RESULTS Short-term changes in psychiatric symptoms and weight were analyzed using latent growth curve modeling . Significant changes in total BDI ( βslope = -0.885 , SE = 0.279 , P < .01 ; βquadratic = 0.054 , SE = 0.021 , P < .001 ) and PedsQL ( βslope = -0.885 , SE = 0.279 , P < .001 ) scores were observed following LAGB , and comparable postoperative changes between psychosocial variables and body mass index were also noted ( BDI : covariance [ COV ] = 0.21 , SE = 0.06 , P < .001 ; PedsQL : COV = -0.41 , SE = 0.10 , P < .01 ) . Two variables ( family conflict/loss of control eating ) were found to be significant predictors of weight change over the year following surgery ( P < .05 ) . CONCLUSIONS Adolescents experienced notable improvements in initial depressive symptoms and quality of life after LAGB , and measures of preoperative binge eating and family conflict affected postsurgery body mass index among youth . TRIAL REGISTRATION Clinical Trials.gov identifier : NCT01045499 The current study investigates the effects of a multidisciplinary lifestyle intervention for obesity on Health Related Quality of Life ( HRQoL ) . In this study , 92 adults with obesity were weighed and completed the Short Form Health Survey ( SF–36 ) and the Center for Epidemiologic Studies Depression Scale ( CES – D ) at the baseline and at the end of a 3-month intervention . Repeated measures analysis of variance ( ANOVA ) , a series of hierarchical regressions , and the statistical mediation analysis of Baron and Kenny were conducted . ( a ) Over 3 months , changes in weight and the mental and physical scales of the SF–36 and depression were all significant . ( b ) The results indicate a significant mediation of changes in depression scores for the association between weight loss and enhancement on the General Health scale of the SF–36 . Improvements to HRQoL from a multidisciplinary lifestyle intervention seem to affect both the physical and mental components of the SF–36 score and to reduce depression , contributing to enhanced self-perceptions of well-being The present study was design ed to evaluate the 3 year effects of a lifestyle intervention on weight loss and maintenance , dietary , and physical activity habits and eating behavior of patients following vertical b and ed gastroplasty ( VBG ) . Thirty severely obese female volunteers were included in the study and they were r and omly assigned to one of two intervention groups : usual care ( UC ) or lifestyle intervention ( LS ) group . Patients were followed for 3 years postoperatively . Outcome measures included weight loss , dietary habits , physical activity level ( PAL ) , and eating behavior changes . Weight was significantly lower in the LS group after 12 months ( 84.4 + /- 3.9 kg vs. 98.4 + /- 4.4 kg , P < 0.05 ) , 24 months ( 83.0 + /- 3.3 vs. 101.9 + /- 5.3 kg , P < 0.05 ) , and 36 months following surgery ( 84.2 + /- 3.3 vs. 102.5 + /- 3.5 kg , P < 0.05 ) . Repeated measures ANOVA revealed significant differences between the two groups overall and at specific time points for the PAL and TV viewing . With regard to eating behavior , the LS group scored significantly better in total Dutch Eating Behavior Question naire ( DEBQ ) , Restraint Eating and External Eating scales at all postoperative time points . Similarly , significant differences were found between the two groups in dietary intake . These findings outline the importance of lifestyle intervention on weight loss and maintenance following bariatric surgery . The favorable effects of lifestyle intervention may be through adoption of healthier eating behaviors and increased physical activity Quality of life improves after  bariatric surgery .  However , long-term results and the influence of reoperations are not well known . A prospect i ve quality of life assessment before , 1 and 7 years after  laparoscopic adjustable gastric b and ing ( LAGB ) and vertical b and ed gastroplasty ( VBG )  was performed in order to determine the influence of reoperations during follow-up . One hundred patients were included in the study . Fifty patients underwent VBG and 50 LAGB .  Patients completed the  quality of life question  naires prior to surgery and two times during follow-up . Health-related quality of life ( HRQoL ) question naires included the Nottingham Health Profile I and II and the Sickness Impact Profile 68 . Follow-up was 84 % with a mean duration of 84 months ( 7 years ) . During follow-up , 65 % of VBG patients underwent conversion to Roux-en-Y gastric bypass while 44 % of LAGB patients underwent a reoperation or conversion . One year after the procedure , nearly all quality -of-life parameters significantly improved . After 7 years , the Nottingham Health Profile (NHP)-I domain “ physical ability ” , the NHP-II and the SIP-68 domains “ mobility control ” , “ social behavior ” , and “ mobility range ” were still significantly improved in both groups . The domains “ emotional reaction ” , “ social isolation ” ( NHP-I ) , and “ emotional stability ” ( SIP-68 ) remained significantly improved in the VBG group while this was true for the domain “ energy level ” ( NHP-I ) in the LAGB group . Both the type of procedure and reoperations during follow-up were not of significant influence on the HRQoL results . Weight loss and decrease in comorbidities were the only significant factors influencing quality of life . Restrictive bariatric surgery improves quality of life . Although results are most impressive 1 year after surgery , the improvement remains significant after long-term follow-up . Postoperative quality of life is mainly dependent on weight loss and decrease in comorbidities and not on the type of procedure or surgical complications Background : Quality of life ( QoL ) was tested in a 2- year postoperative study using the Medical Outcome Study Short Form 36 ( MOS SF-36 ) to assess preoperative and 1 and 2 year postoperative QoL among one group of female patients ( group 1 , n = 42 ) and a 2 year postoperative QoL study in a second group of female patients ( group 2 , n = 9 ) who underwent a stomach reduction operation involving open surgical placement of a Lap-B and during the year 1997 . Methods : The QoL of 42 patients ( group 1 ) was assessed at most 20 hours before surgery and 1 and 2 years ( 12 and 24 months ) postoperatively using a r and omized pre-test/post-test design . The QoL of 9 patients ( group 2 ) was assessed 2 years ( 24 months ) postoperatively using a r and omized post-test design only . The results were compared with the st and ardized Dutch norm data scale . Statistical data were analyzed with SPSS versions 10.0 . Results : The placement of a Lap-B and in group 1 result ed in a significant reduction in Body Mass Index ( BMI ) in the first and second-year follow-up . Mean BMI declined significantly from 40.7 kg/m2 preoperatively to 33.1 kg/m2 at the 1-year follow-up , to 31.3 kg/m2 at 2-year follow-up . In group 2 BMI also declined significantly from 43.0 kg/m2 preoperatively to 34.2 kg/m2 at 1-year follow-up to 32.1 kg/m2 at the 2-year follow-up . Compared to the MOS SF-36 st and ardized Dutch norm data , a significant improvement in the QoL was seen on the effect variable bodily pain , mental health and general health perceptions in group 1 . Although the bodily pain , general health and mental health perceptions increased significantly 2 years postoperatively ( group 1 ) com pared with the Dutch st and ardized norm data , the preoperative general health and mental health perceptions of morbidly obese patients were , like all other preoperative effect variables , not significantly different from the scores on the Dutch st and ardized norm scale . Conclusion : Although other authors found that QoL improves after surgical-induced weight loss , showing significant improvements on patients ' perception of their health status , these findings were not confirmed in the present study . The findings show only a significant difference in bodily pain , general health and mental health perception before and after surgical intervention and preoperatively in group 1 compared to the Dutch st and ardized norm data . Because of small sample size ( n = 9 ) , no significant results were found in group 2 compared to the Dutch St and ardized norm data . Based on earlier and present findings , further study is recommended to ascertain whether the MOS SF-36 is valid in morbidly obese patients and whether the response set has an influence on QoL studies of these patients OBJECTIVE To evaluate the effect of 2 post-bariatric support interventions on depressive symptoms of Hispanic Americans treated with gastric bypass for morbid or severe obesity . DESIGN / SETTING Prospect i ve r and omized , controlled trial conducted in a laparoscopic institution . PARTICIPANTS / INTERVENTIONS During the Phase 1 clinical trial ( from preoperative evaluation to 6 months after surgery ) , all participants received st and ard care . During Phase 2 ( 6 - 12 months after surgery ) , participants were r and omly assigned to receive either st and ard care ( n = 72 ) or comprehensive support ( n = 72 ) . Comprehensive group participants received 6 educational sessions focused on behavior change strategies and motivation with nutrition counseling . MAIN OUTCOME MEASURES Depression scores and weight change over time . ANALYSIS Independent sample s t tests and regression analysis assessed relationships among depression scores and excess weight loss . RESULTS Participants receiving behavioral-motivational intervention scored significantly lower on Beck 's Depression Inventory question naire scores than those receiving st and ard care . For those with depressive symptoms at r and omization , 24 % of participants who received the comprehensive intervention reported no depressive symptoms at 12 months after surgery , compared with 6 % of those who received st and ard care ( P < .001 ) . Patients ' depressive mood improvement was significantly and positively associated with excess weight loss and attendance at educational sessions ( P < .001 ) . CONCLUSIONS AND IMPLICATION S Findings support the importance of post-bariatric comprehensive behavioral-motivational nutrition education for decreasing risk for depression and improving weight loss BACKGROUND Bariatric surgery is a powerful treatment of severe obesity . During the past several years , a greater appreciation for the need for multidisciplinary care to optimize outcomes has developed , and a number of studies have been started to examine the role of postoperative interventions used in combination with surgery . The purpose of the present study was to investigate the hypothesis that the provision of postoperative dietary counseling , delivered by a registered dietitian , would lead to greater weight loss and more positive improvements in dietary intake and eating behavior compared with st and ard postoperative care . The study was performed at an academic medical center . METHODS Eighty-four individuals who underwent bariatric surgery were r and omly assigned to receive either dietary counseling or st and ard postoperative care for the first 4 months after surgery . The participants completed measures of macronutrient intake and eating behavior at baseline and 2 , 4 , 6 , 12 , 18 , and 24 months after surgery . RESULTS The patients who received dietary counseling achieved greater weight loss than those who received st and ard postoperative care that did not involve this counseling , although this difference did not reach statistical significance . Patients in the dietary counseling arm did report significant changes in several eating behaviors believed to be important to successful long-term weight maintenance . CONCLUSION The results of our pilot study provide some support for the efficacy of early postoperative dietary counseling to improve outcomes after bariatric surgery Background Obesity has recently been cited as the number one killer in the USA . This problem is both a national and regional epidemic . The health care costs of obesity and obesity-related illnesses are ever increasing , and gastric bypass surgery is becoming a popular treatment strategy . Recently , reports describe not only surgical outcomes , but also quality of life outcomes . The bigger issue of obesity-related illness resolution is still evolving . Our institution has performed well over 500 gastric bypasses since 2002 . We evaluated over 100 patients prior to and 1 year after gastric bypass surgery .  Methods A prospect i ve study was design ed in order to systematic ally examine quality of life in  gastric bypass patients and couple the results with both objective and subjective assessment of bariatric surgery outcomes . One hundred nineteen patients undergoing gastric bypass at our institution from January 2005 to December of 2005 were enrolled in the study . In addition to routine preprocedural and postprocedural follow-up , completion of  quality of life  forms and anthropometric measurements were performed . Using these data , we then correlated the change in quality of life scores with social factors , weight loss success , and status of obesity-related conditions . We also examined the impact of alcohol intake and other demographic factors on both quality of life and obesity related conditions . Results A total of 119 patients were enrolled in the study during the calendar year 2005 . Follow-up at approximately 1 year ( average 12.86 months ) postsurgery was obtained in 75 patients . A significant reduction in weight ( 144.4 ± 34.4 vs. 91.5 ± 28.8 ; p < 0.0001 ) , body mass index ( 52.4 ± 12.2 vs. 32.3 ± 8.6 ; p < 0.0001 ) , mean systolic blood pressure ( 140.4 ± 14.7 vs. 130.0 ± 21.7 ; p < 0.001 ) , and lipids ( 194.3 ± 33.8 vs. 165.7 ± 32.1 ; p < 0.0001 ) was noted . Quality of life scores 1 year after gastric bypass surgery were also significantly improved ( 35.9 ± 19.5 vs. 82.2 ± 23.5 ; p < 0.0001 ) . There was also a significant reduction in the reported usage of medications for obesity related conditions . Various measures of success ( change in BMI , change in quality of life scores , and follow up health ranking ) were compared across demographic and social factors and no significant associations were identified . Conclusions Gastric bypass is associated with a reduction in weight , BMI , mean systolic blood pressure , cholesterol , and the usage of medications for obesity-related conditions . A significant improvement in quality of life was also noted 1 year after surgery BACKGROUND There is a lack of adequate prospect i ve data on quality -of-life ( QOL ) and its predictors in patients undergoing laparoscopic sleeve gastrectomy ( LSG ) .  The aim of this study was to assess longitudinal changes in QOL after LSG with the use of the obesity-specific Moorehead-Ardelt II question naire ( MAII ) and to identify clinical parameters associated with QOL outcome . METHODS Morbidly obese patients consecutively admitted for LSG , over a 30-month period , were prospect ively studied . QOL was assessed using the vali date d Greek version of the MAII question naire and a visual analogueue scale ( VAS ) , preoperatively and at 6 , 12 , and 24 months postoperatively . Anthropometric data and obesity-related co-morbidities were recorded . RESULTS A total of 111 patients with a mean age 36.8±9.2 years were included . Mean preoperative body mass index ( BMI ) was 49.1±7.5 kg/m2 . Percentage excess BMI loss ( % EBL ) was 51.1±14.9 , 64.2±17.9 and 66.4±18.0 at 6 , 12 , and 24 months , respectively . Postoperatively , all obesity-related co-morbidities were significantly improved . MAII score increased from -.40±1.30 preoperatively to 1.75±.83 , 2.18±.80 , and 1.95±.71 at 6 , 12 , and 24 months postoperatively ( trend P<.001 ) . Preoperative median ( interquartile range ) VAS was 3 ( 1 ) increasing to 9 ( 2 ) , 10 ( 1 ) , and 9 ( 1 ) at 6 , 12 , and 24 months postoperatively ( P<.001 ) . % EBL and reduction in obesity-related co-morbidities , especially resolution of diabetes and sleep apnea , correlated significantly with higher QOL during the course of the study . CONCLUSION LSG , a safe and effective bariatric operation , results in sustained weight loss and significant improvements in QOL . Both weight loss and amelioration of co-morbidities contribute to higher level of postsurgical QOL BACKGROUND The increase in obesity coupled with greater acceptance of the field of bariatric surgery has result ed in a substantial rise in the number of weight-loss operations . Because obese individuals are at high risk for surgical complications , concern about the safety of bariatric procedures exists . Earlier investigations of the clinical features associated with surgical complications have produced conflicting results . We sought to identify risk factors for surgical complications in a large , nationally representative population of US veterans . STUDY DESIGN We analyzed data  on bariatric procedures performed at 12 Veterans ' Affairs medical centers approved to perform weight-loss operations between 1998 and 2004 . Detailed pre- , intra- , and postoperative information and longterm mortality data were prospect ively collected using the National Surgical Quality Improvement Program methodology . We used multivariable logistic regression to identify clinical features associated with postoperative complications . RESULTS Among 575 bariatric patients assessed between 1998 and 2004 , 74 % were men with a mean age of 51 years . Thirty-day mortality was 1.4 % . Overall complication rate was 19.7 % . Of those with complications , one-half were of considerable clinical importance , as they were associated with prolonged length of stay . Clinical features that were predictive of adverse events in our multivariable analyses were superobesity , weight>350 pounds , and smoking . A more than 20 pack-year history of smoking was also associated with difficulty in weaning from a ventilator postoperatively . CONCLUSIONS We identified smoking and superobesity as preoperative risk factors associated with postoperative complications . Future studies should examine the effect of preoperative weight loss and smoking cessation on bariatric procedure outcomes INTRODUCTION Obesity has been described as a risk factor for the development of coronary artery disease , but it has not been determined whether obesity is associated with adverse outcomes after cardiac surgery . Therefore , we analyzed a large cohort of patients who had undergone cardiac surgery to determine whether obesity is a predictor of mortality , morbidity or early readmission to hospital . METHODS At the London Health Sciences Centre , an academic tertiary care centre , we prospect ively entered data from the cardiac surgical data base from July 1999 to April 2002 . We collected data on 1310 consecutive , unselected patients who underwent cardiac surgery during that time . We assessed the degree of obesity using the body mass index ( BMI ) , and we prospect ively documented the occurrence of 10 major complications after surgery . They included stroke , reoperation for bleeding , life-threatening cardiac arrest or arrhythmia , new renal failure requiring dialysis , septicemia , mediastinitis , sternal dehiscence , respiratory failure , postoperative myocardial infa rct ion and low cardiac output necessitating intra-aortic balloon pump use . Univariable and multivariable analyses were conducted to determine the factors associated with and predictive of postoperative death and major complications . RESULTS An increased BMI did not increase the risk of early postoperative death . Furthermore , increased BMI was not a predictor of a patient experiencing any of the major complications , except sternal dehiscence . An increased BMI was associated with a higher likelihood of readmission to hospital within 30 days of discharge . CONCLUSION Obesity was not associated with adverse outcomes after cardiac operations , aside from the increased risks of sternal dehiscence and early hospital readmission
The average impact of bariatric surgery on quality of life corresponded to an effect size of 0.88 ( 95 % CI : 0.80 - 0.96 ) , indicating that bariatric surgery has a significant positive influence on quality of life in general .
The impact varied considerably across studies with bariatric surgery showing a significantly greater positive influence on physical quality of life compared to mental quality of life .
Bariatric surgery is effective in improving quality of life , especially when looking at physical well-being .
Greater focus on the psychological well-being of the person undergoing surgery for obesity may lead to a better post-surgery prognosis for more people
This study aims to review the obesity literature in order to assess the impact of bariatric surgery on quality of life and the between- study variation by examining the st and ardized mean magnitude of effect in change in the levels of quality of life .