Predictors of Changes in Health-Related Quality of Life 6 and 12 months After a Bariatric Procedure.

BACKGROUND: Bariatric surgery is an effective method for treating morbid obesity and improving patients' health-related quality of life (HRQoL). As research on predictors that contribute to the amelioration of HRQoL is sparse, our prospective study was conducted to examine the predictive value of demographic, psychological and physiological variables on physical and mental HRQoL 6 and 12 months after surgery.

METHODS: We surveyed 154 participants who had undergone either a laparoscopic Roux-en-Y gastric bypass (LRYGB) or a laparoscopic sleeve gastrectomy (LSG). Prior to surgery and both 6 and 12 months after the procedure, patients completed questionnaires concerning their demographic data, height and weight, co-morbid conditions, HRQoL (Short Form Health Survey-12), depression severity (Beck Depression Inventory-II), and eating psychopathology (Eating Disorder Examination-Questionnaire). Multiple linear regression analyses were conducted to detect predictors of physical and mental HRQoL 6 and 12 months post-operation.

RESULTS: The predictors included within the models explained 50 to 58% of the variance of post-operative physical and mental HRQoL, respectively. Higher baseline depression severity was associated with reduced HRQoL after surgery, whereas changes from pre- to post-surgery in BDI-II scores positively predicted HRQoL values, especially mental HRQoL. The persistence of somatic co-morbid disorders had a negative effect on physical HRQoL.

CONCLUSIONS: Depression severity before surgery and changes in depression scores were found to be major predictors of HRQoL after bariatric surgery. Therefore, we recommend screening patients regularly for depression both before and after bariatric surgery and offering them adequate psychotherapeutic and/or psychopharmacologic support.