Improvement in quality of life after bariatric surgery: sleeve versus bypass

Background: Obesity is steadily growing to be the largest threat to human health in this century, not only increasing prevalence of obesity-related co-morbidity but also impairing health-related quality of life (QoL). Bariatric surgery has shown to improve co-morbidity as well as QoL. Objectives: To assess the differences in improvement in QoL for the 2 most performed procedures: laparoscopic sleeve gastrectomy (SG) and laparoscopic Roux-en-Y gastric bypass (RYGB). Setting: Obesity center, the Netherlands. Methods: All patients who underwent either SG or RYGB as a primary operation from January 2012 until January 2017 were eligible. Included, were only those who completed preoperatively and 1-year postoperatively the QoL questionnaire. The RAND 36-item Health Survey was used to assess QoL. Results: A total of 1184 cases were included in analysis of which 666 patients underwent SG and 518 patients underwent RYGB. Groups significantly differed in body mass index, weight, waist circumference, prevalence of gastroesophageal reflux disease, obstructive sleep apnea syndrome, and hypertension. All QoL domains greatly improved after bariatric surgery. Physical functioning increased more in patients who underwent gastric bypass. This remained significant after correcting for differences between groups. Other domains were not significantly different. Conclusion: QoL is greatly improved at 1 year after bariatric surgery. The improvement was comparable after SG and RYGB, expect for more increase in physical functioning after RYGB. QoL could influence decision-making between SG and RYGB. So far, no clinically relevant differences were found. Future research should focus on both longer follow-up and more specific questionnaires. (C) 2018 American Society for Metabolic and Bariatric Surgery. All rights reserved.