SURGERY FOR SEVERELY OBESE IMPROVES MORE THAN JUST WEIGHT
COLUMBUS, Ohio -- New research suggests that the results of surgery to treat severe obesity reach beyond helping patients feel better about their weight. Rather, it helps patients feel they had shed a major disability.
When researchers compared obese patients to a non-obese population, they found significant improvement for obese patients in eight categories of well-being after gastric bypass surgery. While the obese patients improved in each area, they even surpassed the control group of non-obese people in four categories of well-being.
This study begins to document how big a disability obesity is for individuals, said Patricia Choban, an adjunct professor of human nutrition and food management at Ohio State University. When the disability is taken away, its like un-handicapping the racehorses.
The research appears in a recent issue of the Journal of the American College of Surgeons.
Choban and her colleagues looked at the health perception outcomes in 53 patients following Roux-en-Y gastric bypass surgery, a procedure to help people lose weight. We looked at the effects of this treatment on quality of life as seen from the patients perspective, she said.
The researchers assessed 53 obese patients in eight categories of well-being: physical activities; social functioning; physical and emotional factors; pain relief; general mental health; vitality; and general health perceptions. Physical and emotional factors dealt with how obesity affected what the subject needed to do on a day-to-day basis.
Each subject filled out a questionnaire one week prior to surgery and again three to 12 months after surgery and again after their weight had reached a plateau (usually 18 or more months after the operation.) Patients were candidates for surgery if they had a body mass index of 40 kg/m2 or greater or a BMI of 35 kg/m2 with the presence of obesity-related conditions, such as hypertension or diabetes. The average patient in this study had a BMI of 51 kg/m2.
BMI uses height and weight measurements to roughly determine whether or not a person is at risk for obesity-related health disorders. A person with a BMI of 27 kg/m2 or greater is usually considered overweight and at risk for obesity-related health problems.
Each subject underwent Roux-en-Y gastric bypass, a procedure which essentially reduces the size of the stomach by three-quarters of its size, to about an ounce. This helps patients to eat less. The patients lost an average of 95 pounds during the 18 months following the surgery, and BMI measurements fell from an average of 51 kg/m2 before the operations to an average of 35 kg/m2 18 months later.
While the BMI measurements were still considered high, the patients attitudes toward their health had markedly improved, said Choban. The researchers asked the patients to compare their current health status to their perceptions of health one year before surgery. When their weight loss had reached a plateau, 74 percent said their health was better than it had been one year earlier.
Patient attitudes improved in all categories, sometimes surpassing the control population the researchers used for comparison. After surgery, the subjects felt significantly better than the normal population in the areas of social functioning, emotional well-being, pain relief and vitality.
And while it seems obvious that weight reduction surgery would make the subjects feel good about themselves, the results seemed to go beyond just being glad about the weight loss, Choban said.
Treating clinically severe obesity with surgery had a profoundly positive impact on the patients perception of their health status, Choban said.
She co-authored the study with Jacqueline Onyejekwe, a current medical student at Ohio State; Jean Burge, a nutritionist at Hoffman LaRoche; and Louis Flancbaum, now an associate professor of surgery at Columbia University.