Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Obesity Surgery
Published in: Obesity Surgery 11/2019

Open Access 01-11-2019 | Obesity | Original Contributions

The Influence of Socioeconomic Factors on Quality-of-Life After Laparoscopic Gastric Bypass Surgery

Authors: Karin Gryth, Carina Persson, Ingmar Näslund, Magnus Sundbom, Erik Näslund, Erik Stenberg

Published in: Obesity Surgery | Issue 11/2019

Login to get access

Abstract

Introduction

Patients with low socioeconomic status have been reported to experience poorer outcome after several types of surgery. The influence of socioeconomic factors on health-related quality-of-life (HRQoL) after bariatric surgery is unclear.

Materials and Methods

Patients operated with a primary laparoscopic gastric bypass procedure in Sweden between 2007 and 2015 were identified in the Scandinavian Obesity Surgery Register. Patients with a completed assessment of health-related quality-of-life based on the Obesity-related Problem Scale (OP Scale) were included in the study. Socioeconomic status was based on data from Statistics Sweden.

Results

A total of 13,723 patients (32% of the 43,096 operated during the same period), with complete OP scores at baseline and two years after surgery, were included in the study. Age, lower preoperative BMI, male gender, higher education, professional status and disposable income as well as not receiving social benefits (not including retirement pension), and not a first- or second-generation immigrant, were associated with a higher postoperative HRQoL. Patients aged 30–60 years, with lower BMI, higher socioeconomic status, women and those born in Sweden by Swedish parents experienced a higher degree of improvement in HRQoL. Postoperative weight-loss was associated with higher HRQoL (unadjusted B 16.3, 95%CI 14.72–17.93, p < 0.0001).

Conclusion

At 2 years, a strong association between weight loss and improvement in HRQoL was seen, though several factors influenced the degree of improvement. Age, sex, preoperative BMI and socioeconomic status all influence the postoperative HRQoL as well as the improvement in HRQoL after laparoscopic gastric bypass surgery.
Literature
1.
Must A, Spadano J, Coakley EH, et al. The disease burden associated with overweight and obesity. JAMA. 1999;282(16):1523–9.CrossRefPubMed
2.
Field AE, Coakley EH, Must A, et al. Impact of overweight on the risk of developing common chronic diseases during a 10-year period. Arch Intern Med. 2001;161(13):1581–6.CrossRefPubMed
3.
Renehan AG, Tyson M, Egger M, et al. Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies. Lancet. 2008;371(9612):569–78.CrossRefPubMed
4.
Fontaine KR, Redden DT, Wang C, et al. Years of life lost due to obesity. JAMA. 2003;289(2):187–93.CrossRefPubMed
5.
6.
Sjostrom L, Narbro K, Sjostrom CD, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357(8):741–52.CrossRef
7.
Sjostrom L, Gummesson A, Sjostrom CD, et al. Effects of bariatric surgery on cancer incidence in obese patients in Sweden (Swedish Obese Subjects Study): a prospective, controlled intervention trial. Lancet Oncol. 2009;10(7):653–62.CrossRefPubMed
8.
Sundbom M, Hedberg J, Marsk R, et al. Substantial decrease in comorbidity 5 years after gastric bypass: a population-based study from the Scandinavian Obesity Surgery Registry. Ann Surg. 2017;265(6):1166–71.CrossRefPubMed
9.
Megias A, Gonzalez-Cutre D, Beltran-Carrillo VJ, et al. The impact of living with morbid obesity on psychological need frustration: a study with bariatric patients. Stress Health. 2018;34(4):509–22.CrossRefPubMed
10.
Kolotkin RL, Crosby RD, Williams GR, et al. The relationship between health-related quality of life and weight loss. Obes Res. 2001;9(9):564–71.CrossRefPubMed
11.
Karlsson J, Taft C, Sjostrom L, et al. Psychosocial functioning in the obese before and after weight reduction: construct validity and responsiveness of the Obesity-related Problems scale. Int J Obes Relat Metab Disord. 2003;27(5):617–30.CrossRefPubMed
12.
Kolotkin RL, Kim J, Davidson LE, et al. 12-year trajectory of health-related quality of life in gastric bypass patients versus comparison groups. Surg Obes Relat Dis. 2018;14(9):1359–65.CrossRefPubMed
13.
Raoof M, Naslund I, Rask E, et al. Health-related quality-of-life (HRQoL) on an average of 12 years after gastric bypass surgery. Obes Surg. 2015;25(7):1119–27.CrossRefPubMed
14.
Martin M, Beekley A, Kjorstad R, et al. Socioeconomic disparities in eligibility and access to bariatric surgery: a national population-based analysis. Surg Obes Relat Dis. 2010;6(1):8–15.CrossRefPubMed
15.
Wallace AE, Young-Xu Y, Hartley D, et al. Racial, socioeconomic, and rural-urban disparities in obesity-related bariatric surgery. Obes Surg. 2010;20(10):1354–60.CrossRefPubMed
16.
Stenberg E, Persson C, Näslund E, et al. The impact of socioeconomic factors on the early postoperative complication rate after laparoscopic gastric bypass surgery. Surg Obes Relat Dis. 2019;15(4):575–81.CrossRefPubMed
17.
Courtney PM, Huddleston JI, Iorio R, et al. Socioeconomic risk adjustment models for reimbursement are necessary in primary total joint arthroplasty. J Arthroplast. 2017;32(1):1–5.CrossRef
18.
Goljo E, Parasher AK, Iloreta AM, et al. Racial, ethnic, and socioeconomic disparities in pituitary surgery outcomes. Laryngoscope. 2016;126(4):808–14.CrossRef
19.
Olbers T, Lonroth H, Fagevik-Olsen M, et al. Laparoscopic gastric bypass: development of technique, respiratory function, and long-term outcome. Obes Surg. 2003;13(3):364–70.CrossRef
20.
Holm S. A simple sequentially rejective multiple test procedure. Scand J Stat. 1979;6(2):65–70.
21.
Larsson U, Karlsson J, Sullivan M. Impact of overweight and obesity on health-related quality of life--a Swedish population study. Int J Obes Relat Metab Disord. 2002;26(3):417–24.CrossRefPubMed
22.
Dreber H, Thorell A, Reynisdottir S, et al. Health-related quality of life 5 years after Roux-en-Y gastric bypass in young (18-25 years) versus older (>/= 26 years) adults: a Scandinavian Obesity Surgery Registry Study. Obes Surg. 2019;29(2):434–43.CrossRefPubMed
23.
Andersen JR, Aasprang A, Karlsen TI, et al. Health-related quality of life after bariatric surgery: a systematic review of prospective long-term studies. Surg Obes Relat Dis. 2015;11(2):466–73.CrossRefPubMed
24.
Puhl RM, King KM. Weight discrimination and bullying. Best Pract Res Clin Endocrinol Metab. 2013;27(2):117–27.CrossRefPubMed
25.
26.
Kolotkin RL, Crosby RD, Williams GR. Health-related quality of life varies among obese subgroups. Obes Res. 2002;10(8):748–56.CrossRefPubMed
27.
Varban OA, Cassidy RB, Bonham A, et al. Factors associated with achieving a body mass index of less than 30 after bariatric surgery. JAMA Surg. 2017;152(11):1058–64.CrossRefPubMedPubMedCentral
28.
Rowlands G, Protheroe J, Winkley J, et al. A mismatch between population health literacy and the complexity of health information: an observational study. Br J Gen Pract. 2015;65(635):e379–86.CrossRefPubMedPubMedCentral
29.
Johnson TV, Abbasi A, Kleris RS, et al. Assessment of single-item literacy questions, age, and education level in the prediction of low health numeracy. JAAPA. 2013;26(8):50–4.CrossRefPubMed
30.
Kolt GS, George ES, Rebar AL, et al. Associations between quality of life and duration and frequency of physical activity and sedentary behaviour: baseline findings from the WALK 2.0 randomised controlled trial. PLoS One. 2017;12(6):e0180072.CrossRefPubMedPubMedCentral
31.
Kunst AE, Bos V, Lahelma E, et al. Trends in socioeconomic inequalities in self-assessed health in 10 European countries. Int J Epidemiol. 2005;34(2):295–305.CrossRefPubMed
32.
Carden A, Blum K, Arbaugh CJ, et al. Low socioeconomic status is associated with lower weight-loss outcomes 10-years after Roux-en-Y gastric bypass. Surg Endosc. 2019;33(2):454–9.CrossRefPubMed
33.
Brydsten A, Hammarstrom A, San Sebastian M. Health inequalities between employed and unemployed in northern Sweden: a decomposition analysis of social determinants for mental health. Int J Equity Health. 2018;17(1):59.CrossRefPubMedPubMedCentral
34.
Lindstrom M. Marital status, social capital, material conditions and self-rated health: a population-based study. Health Policy. 2009;93(2–3):172–9.CrossRefPubMed
35.
36.
Aarts MA, Sivapalan N, Nikzad SE, et al. Optimizing bariatric surgery multidisciplinary follow-up: a focus on patient-centered care. Obes Surg. 2017;27(3):730–6.CrossRefPubMed
Metadata
Title
The Influence of Socioeconomic Factors on Quality-of-Life After Laparoscopic Gastric Bypass Surgery
Authors
Karin Gryth
Carina Persson
Ingmar Näslund
Magnus Sundbom
Erik Näslund
Erik Stenberg
Publication date
01-11-2019
Publisher
Springer US
Published in
Obesity Surgery / Issue 11/2019
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-019-04028-7

Other articles of this Issue 11/2019

Obesity Surgery 11/2019 Go to the issue

Original Contributions

Gastroesophageal Reflux After Sleeve Gastrectomy: New Onset and Effect on Symptoms on a Prospective Evaluation

Original Contributions

Changes in Body Composition, Comorbidities, and Nutritional Status Associated with Lower Weight Loss After Bariatric Surgery in Older Subjects

Original Contributions

Laparoscopic Sleeve Gastrectomy After Endoscopic Sleeve Gastroplasty: Technical Aspects and Short-Term Outcomes

Original Contributions

Reinforced POSE: the 18-Plication Solution

Original Contributions

Modern Esophageal Function Testing and Gastroesophageal Reflux Disease in Morbidly Obese Patients

Original Contributions

Laparoscopic Sleeve Gastrectomy for High-Risk Patients in a Monocentric Series: Long-Term Outcomes and Predictors of Success