Weight-Loss Surgery and Quality of Life

If you or someone you love is severely overweight, weight-loss surgery may be an option for a longer, healthier life.

People with substantial weight problems may have trouble getting around. Simple household tasks can be difficult. Stairs are a problem, as is walking any distance. Some aspects of personal hygiene can be difficult to maintain. Even tying your shoes or crossing your legs may not be possible. These types of personal limitations can greatly reduce your quality of life.

Faced with diminished physical ability, many severely overweight people may become convinced that things will only get worse. They may lose hope that a healthier future is possible. However, they should not despair.

Ample research-based evidence has shown that weight-loss surgery, as part of a life-long weight management program, can dramatically reverse many weight-related health problems and can greatly improve your quality of life. Even if you have or are developing such weight-related diseases as diabetes, osteoarthritis, sleep apnea, and high blood pressure, you still have effective treatment options to consider. The sooner you act, the better off you will be. In fact, you may actually prevent new health problems from developing.

Who Is a Candidate?
Your doctor is your best resource for finding out more about whether weight-loss surgery is right for you. Usually, the history of a patient's health and objective measures of weight are used to determine whether surgery is an option.

In general, candidates for weight-loss surgery meet all of the following criteria:

  • A body mass index (BMI) of more than 40, or roughly 100 pounds (lb) or more, is considered seriously overweight for men; a BMI of more than 35, or 80 lb or more is considered seriously overweight for women, plus a history of associated medical disorders, such as diabetes, cardiopulmonary disease and obesity-induced musculoskeletal problems
  • Aged at least 18 years, though some younger people may also be candidates
  • A history of unsuccessful attempts at nonsurgical weight-loss treatments

A person who undergoes weight-loss surgery needs to make a lifelong commitment to a new lifestyle, including a new nutrition and exercise regimen, otherwise weight-loss surgery will probably not be effective.

Better Quality of Life
Research shows that maximum weight loss usually reaches about 70 percent of the excess weight after gastric bypass surgery, and 51 percent of the excess weight after adjustable gastric band surgery two years postoperative. However, the weight loss from both types of surgeries is equal after three to five years. There is also a tendency to regain some weight with gastric bypass, with the average excess weight lost remaining stable at 50 percent to 55 percent from five years to as long as 16 years after surgery.

Weight-related health problems will also improve, sometimes dramatically. Sleep apnea tends to disappear entirely with both gastric bypass and adjustable gastric banding. In addition, many patients see marked improvement in diabetes, asthma, blood pressure and muscle and joint pain.

The outcome from weight-loss surgery should not be measured solely by weight loss and improvements in medical conditions. After a substantial portion of the excess weight is lost and a patient's health improves, the improvement in quality of life is an equally important outcome.

You may find yourself able to do things you haven't done in years. You may also find that you are better able to live your life in the way you want to.

In studies that have sought to rate a patient's quality of life before and after weight-loss surgery, obesity has been shown to significantly lower a patient's rating of his or her quality of life. The primary objective of weight-loss surgery is to reduce the numerous consequences that may result from being very overweight, by improving a patient's health status, activity level, engagement in life and work productivity.

The authors of one quality-of-life study wrote that they were "quite surprised" to find that, in as little as two to four weeks after surgery, significant improvements were seen in their patients' perception of their overall health, depression and self-esteem. The researchers also found significant changes in energy levels and physical functioning much sooner after surgery than expected. Between several weeks and six months after surgery, patients showed improvements "on all measures assessed."

Many weight-loss surgery candidates have been very overweight for most of their lives and have had to adapt to the many physical, emotional and social consequences of obesity. Dramatic quality-of-life changes can occur after surgery, so patients need to be prepared. It is wise to expect that you may need some help coping with these challenges and the feelings they may generate.

Talk to Your Doctor
If you think you may be a candidate for the surgical treatment of obesity, the first step is to discuss the situation with your doctor. Together, you can consider how being overweight has affected your health and your life, and whether surgery would be a good option.

1. MacDonald KG, Schauer PR, Brolin RE, Scopinaro N, O'Brien P, Doherty C. Bariatric surgery: a review. Gen Surg News. 2002;29:19-26. 2. Gastric bypass. Medline Plus® Web site, US National Library of Medicine and the National Institutes of Health. Available at: http://www.nlm.nih.gov/medlineplus/print/ency/article/007199.htm. Accessed March 20, 2006. 3. Dymek M, Le Grange D, Neven K, Alverdy J. Quality of life after gastric bypass surgery: a cross-sectional study. Obes Res. 2002;10:1135-1142.

Supported through an educational grant from Allergan Inc.

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