Article
Weight loss and psychological functioning 9 years after bariatric surgery – Results from the multicentre, prospective Essen-Bochum Obesity Treatment Study (EBOTS)
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Authors
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Stephan Herpertz
- Ruhr-Universität Bochum, Bochum, Germany
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Tanja Legenbauer
- Ruhr-Universität Bochum, Bochum, Germany
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Ramona Burgmer
- Universität Bochum, Bochum, Germany
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Ross Crosby
- Neuropsychiatric Research Institute Fargo, Fargo, North Dakota, United States
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Martina de Zwaan
- Med. Hochschule Hannover, Hannover, Germany
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Astrid Müller
- Med. Hochschule Hannover, Hannover, Germany
| Published: | March 17, 2014 |
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Outline
Text
Background: To examine the long-term effects of bariatric surgery (BS) on psychological functioning and quality of life.
Material/Methods: Obese individuals undergoing BS, obese individuals participating in a conventional weight loss treatment (CONV), and obese controls were investigated in a prospective longitudinal study. BMI, QoF (SF-36), anxiety and depression (HADS), and self-esteem (Rosenberg Self-Esteem Scale, RSES) were assessed before treatment, and after 1, 2, 4, and 9 years after treatment. Drop-out rate ranged between 55% and 65%.
Results: Weight loss was significantly greater for the BS compared to the other groups at all assessment points. The CONV group showed more weight loss than controls at the 1- and 2-year assessments, but did not differ significantly from the control group at the 4- and 9-year assessments. The BS group reported significantly greater improvements in SF-36 physical component scores at all post-baseline assessments compared to the other groups. On the SF-36 mental component, the BS group experienced significantly less improvements than controls at the 2-year assessment and significantly less improvements than both the CONV and control group at the 9-year assessment. No differences were found between the BS group and the CONV group on changes in depression at any assessment point. While the BS group showed significantly greater improvements than the control group in depression scores at 1-year, improvements were significantly higher in the control group compared to the BS group at the 9-year assessment. Furthermore, depression scores for the BS group at the 9-year assessment were significantly increased from the 4-year assessment and did not differ significantly from baseline levels. No significant differences were observed between the BS and CONV groups in changes in anxiety scores at any assessment point. In the BS group anxiety increased significantly from the 4- to the 9-year assessment. Of note, 9-year anxiety scores did not differ significantly but were even somewhat higher than pre-surgical scores.
Conclusion: BS results in long-term weight loss and improvement of physical aspects of QoL. However, after initial significant improvement psychological functioning and mental aspects of QoL deteriorated significantly in the BS group from the 4- to 9-year assessment and were comparable to pre-surgical levels.
