Abstract
BackgroundThe preferred surgical procedure for treating morbid obesity is debated. Patient-reported outcome measures (PROMs) are relevant for evaluation of the optimal bariatric procedure.MethodsA total of 113 patients with BMI from 50 to 60 were randomly assigned to standard (n = 57) or distal (n = 56) Roux-en-Y gastric bypass (RYGB). Validated PROMS questionnaires were completed at baseline and 2 years after surgery. Data were analyzed using mixed models for repeated measures and the results are expressed as estimated means and mean changes.ResultsObesity-related quality of life improved significantly after both procedures, without significant between-group differences (− 0.4 (95% CI = − 8.4, 7.2) points, p = 0.88, ES = 0.06). Both groups had significant reductions in the number of weight-related symptoms and symptom distress score, with a mean group difference (95% CI) of 1.4 (− 0.3, 3.3) symptoms and 5.0 (2.9. 12.8) symptom distress score points. There were no between-group differences for uncontrolled eating (22.0 (17.2–26.7) vs. 28.9 (23.3–34.5) points), cognitive restraint (57.4 (52.0–62.7) vs. 62.1 (57.9–66.2) points), and emotional eating (26.8 (20.5–33.1) vs. 32.6 (25.5–39.7) points).The prevalence of anxiety was 33% after standard and 25% after distal RYGB (p = 0.53), and for depression 12 and 9%, respectively (p = 0.76).ConclusionsThere were no statistically significant differences between standard and distal RYGB 2 years post surgery regarding weight loss, obesity-related quality of life, weight-related symptoms, anxiety, depression, or eating behavior.Trial RegistrationClinical Trials.gov number NCT00821197
Highlights
Bariatric surgery may induce sustained weight loss, improvement of weight-associated comorbidities, and improved health and well-being [1, 2]
Most of the improvement in health-related quality of life (HRQOL) and weight-related symptoms occurred during the first year, with only small changes between 1 and 2 years after surgery
We found improvements in most Patient-reported outcome measures (PROMs) after both standard and distal Rouxen-Y gastric bypass (RYGB), but no significant differences between groups after surgery in regard to obesity-specific HRQOL, weight-related symptoms, anxiety and depression, or eating behavior
Summary
Bariatric surgery may induce sustained weight loss, improvement of weight-associated comorbidities, and improved health and well-being [1, 2]. The preferred surgical procedure is debated, for patients with a BMI of 50 kg/ m2 or more [3]. Several variants of RYGB exist with remarkably consistent effects on weight loss [5,6,7,8]. To improve the effectiveness of RYGB, attention has been on the length of the common channel or the biliopancreatic limb [12, 13]. The distal RYGB is a variant with a relatively short common channel that may improve weight loss [14]. Patient-reported outcome measures (PROMs) are relevant for evaluation of the optimal bariatric procedure. Methods A total of 113 patients with BMI from 50 to 60 were randomly assigned to standard (n = 57) or distal (n = 56) Rouxen-Y gastric bypass (RYGB). Data were analyzed using mixed models for repeated measures and the results are expressed as estimated means and mean changes
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