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Long-term health and psychosocial outcomes from surgically induced weight loss: results obtained in patients not attending protocolled follow-up visits

International Journal of Obesity volume 31, pages 299–307 (2007)Cite this article

Abstract

Objective:

Obesity management is focused at weight loss to obtain health, psychological and social benefits. Outcomes from controlled trials, however, do not reflect the everyday routine practice. Therefore, we aimed to investigate the results from surgically induced weight loss in patients devoid of a protocol-wise follow-up, who were visited at home.

Patients and methods:

Patients who underwent a vertical banded gastroplasty or a gastric bypass between 1980 and 1997 were eligible. Body weight and height were measured. Patients filled out questionnaires on health status (Nottingham Health Profile (NHP)), psychological symptoms (Symptom Check List (SCL-90-R)), personality traits (Dutch Personality Questionnaire (DPQ)) and eating behaviour (Dutch Eating Behaviour Questionnaire (DEBQ)).

Results:

Out of 451 operated patients the addresses of 313 subjects could be traced and 236 (75%) agreed to participate. They maintained a mean (s.d.) loss of 32.1 (22.6) kg and 45.2 (29.3) % of excess weight, 8.2 (4.5) years after the operation, about two-third of the largest weight loss they achieved after 17 months postoperatively. The NHP and SCL-90-R conformed to norm values in males except for energy, sleep and emotional reactions. Females differed from norm values in every aspect and even women achieving a BMI<30 kg/m2 did not catch up to norm values. Weight loss was inversely related to physical immobility and pain. Personality traits (DPQ) showed a higher grievance and dominance and a lower rigidity and self-esteem compared to norm values. Females scored higher in inadequacy and lower in social inadequacy. Eating patterns (DEBQ) showed mainly emotional eating and restrained eating. Effect sizes of ⩾0.8 s.d. were chosen to reflect the clinical relevance of statistically significant findings. Pain, disturbances in sleep, energy and mobility and emotional and restrained eating proved to be clinically relevant. In subjects operated >5 years ago, a higher sensitivity, a higher inadequacy and a lower social inadequacy were observed compared to more recently operated subjects. A more restrained eating pattern was related to an operation of recent date.

Conclusions:

Surgically induced weight losses are satisfactory in the long-term, even in patients not attending a strict follow-up protocol. Health, psychological symptoms, personality traits and eating behaviour were related to weight loss and time lapse since the operation and did not return to reference normal-weight subject values.

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Author notes

  1. E M H Mathus-Vliegen: Dutch Bariatric Surgery Group are listed in Appendix 1.

Authors and Affiliations

  1. EMH Mathus-Vliegen, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands

    E M H Mathus-Vliegen

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on behalf of the Dutch Bariatric Surgery Group

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Correspondence to E M H Mathus-Vliegen.

Appendix 1

Appendix 1

Dutch Bariatric Surgery Group: Principal investigator, responsible for the design, analysis and report of the study: Professor Dr EMH Mathus-Vliegen, Gastroenterologist, Professor in Clinical Nutrition, Amsterdam.Co-investigators: Professor Dr H Obertop, Professor of Surgery, Amsterdam; Professor Dr DJ Gouma, Professor of Surgery, Amsterdam; Jolanda Schade, Anouk Storm, Merlyn Christe, Ferry Nobrega and Tanja de Rijp, medical students, University of Amsterdam.Participating surgeons: Professor Dr HA Bruining, Professor of Surgery, Rotterdam; Dr WF Eggink, surgeon, Arnhem; Dr HWF Hoitsma, surgeon, Amsterdam; Dr JWM Greve, surgeon, Maastricht; Dr MAJM Hunfeld, surgeon, Beverwijk; Dr LWM Janssen, surgeon, Utrecht; Professor Dr J Jeekel, Professor of Surgery, Rotterdam; Professor Dr CJ van der Linden, Professor of Surgery, Nijmegen; Dr M Lopez Cardozo, surgeon, Zwolle; Dr RJ Oostenbroek, surgeon, Dordrecht; Dr MKM Salu, surgeon, Rotterdam; Professor Dr PB Soeters, Professor of Surgery, Maastricht; Dr B van Ramshorst, surgeon, Nieuwegein; Dr W van Rooyen, surgeon, Zwolle; Dr WE Tuinebreyer, surgeon, Beverwijk; Dr LT de Wit, surgeon, Amsterdam.

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Mathus-Vliegen, E., on behalf of the Dutch Bariatric Surgery Group. Long-term health and psychosocial outcomes from surgically induced weight loss: results obtained in patients not attending protocolled follow-up visits. Int J Obes 31, 299–307 (2007). https://doi.org/10.1038/sj.ijo.0803404

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