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Published in: Obesity Surgery 1/2013

01-01-2013 | Clinical Research

Plastic Surgery After Gastric Bypass Improves Long-Term Quality of Life

Authors: A. Modarressi, N. Balagué, O. Huber, M. Chilcott, B. Pittet-Cuénod

Published in: Obesity Surgery | Issue 1/2013

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Abstract

Background

Excess skin after massive weight loss impairs patient’s health-related quality of life (HRQoL). Therefore, body-contouring surgeries can be proposed. However, few data exist concerning the effect of body contouring after bariatric surgery on HRQoL, including control group with a long-term follow-up.

Methods

In a prospective study, 98 consecutive patients who had body contouring after gastric bypass for obesity (BMI > 40) were included (group A). A matched control-group containing 102 patients who had only gastric bypass was selected (group B). HRQoL was measured by Moorehead–Ardelt questionnaire before (group A1) and after (A2) body contouring, and at different time points for group B until 8 years post-gastric bypass. To evaluate the effect of body contouring by two parallel methods, HRQoL was compared between groups A1 and A2, and between A2 and B.

Results

We found that body contouring procedures improved significantly patients’ HRQoL, in comparison to those who had only gastric bypass. Of the patients who had body contouring (group A2), 57 % evaluated their HRQoL “much better” in comparison to only 22 % of patients before body contouring (group A1) or those who never had body contouring (group B) (p < 0.001). The improvement was significant in all sub-domains of HRQoL: self-esteem, social life, work ability, sexual activity and physical activity (p < 0.001), and remained stable over time.

Conclusions

Our study confirms the important role of plastic surgery in treatment of patients after massive weight loss. We demonstrated that body contouring, despite important scars, significantly improves satisfaction and HRQoL of patients after gastric bypass. Therefore, the treatment of morbid obesity should not be deemed achieved unless plastic surgery has been considered.
Literature
1.
go back to reference Berrington de Gonzalez A, et al. Body-mass index and mortality among 1.46 million white adults. N Engl J Med. 2010;363(23):2211–9.PubMedCrossRef Berrington de Gonzalez A, et al. Body-mass index and mortality among 1.46 million white adults. N Engl J Med. 2010;363(23):2211–9.PubMedCrossRef
2.
go back to reference Allison DB, Saunders SE. Obesity in North America. An overview. Med Clin N Am. 2000;84(2):305–32. v.PubMedCrossRef Allison DB, Saunders SE. Obesity in North America. An overview. Med Clin N Am. 2000;84(2):305–32. v.PubMedCrossRef
3.
go back to reference Sarwer DB, Wadden TA, Fabricatore AN. Psychosocial and behavioral aspects of bariatric surgery. Obes Res. 2005;13(4):639–48.PubMedCrossRef Sarwer DB, Wadden TA, Fabricatore AN. Psychosocial and behavioral aspects of bariatric surgery. Obes Res. 2005;13(4):639–48.PubMedCrossRef
5.
go back to reference Di Gregorio JM, Palkoner R. Quality of life after obesity surgery, an evidence-based medicine literature review: how to improve systematic searches for enhanced decision-making and clinical outcomes. Obes Surg. 2001;11(3):318–26.PubMedCrossRef Di Gregorio JM, Palkoner R. Quality of life after obesity surgery, an evidence-based medicine literature review: how to improve systematic searches for enhanced decision-making and clinical outcomes. Obes Surg. 2001;11(3):318–26.PubMedCrossRef
6.
go back to reference Buchwald H, et al. Bariatric surgery: a systematic review and meta-analysis. Jama. 2004;292(14):1724–37.PubMedCrossRef Buchwald H, et al. Bariatric surgery: a systematic review and meta-analysis. Jama. 2004;292(14):1724–37.PubMedCrossRef
7.
go back to reference Maggard MA, et al. Meta-analysis: surgical treatment of obesity. Ann Intern Med. 2005;142(7):547–59.PubMed Maggard MA, et al. Meta-analysis: surgical treatment of obesity. Ann Intern Med. 2005;142(7):547–59.PubMed
8.
go back to reference Dymek MP, et al. Quality of life after gastric bypass surgery: a cross-sectional study. Obes Res. 2002;10(11):1135–42.PubMedCrossRef Dymek MP, et al. Quality of life after gastric bypass surgery: a cross-sectional study. Obes Res. 2002;10(11):1135–42.PubMedCrossRef
9.
go back to reference van Gemert WG, et al. Psychological functioning of morbidly obese patients after surgical treatment. Int J Obes Relat Metab Disord. 1998;22(5):393–8.PubMedCrossRef van Gemert WG, et al. Psychological functioning of morbidly obese patients after surgical treatment. Int J Obes Relat Metab Disord. 1998;22(5):393–8.PubMedCrossRef
10.
go back to reference Hell E, et al. Evaluation of health status and quality of life after bariatric surgery: comparison of standard Roux-en-Y gastric bypass, vertical banded gastroplasty and laparoscopic adjustable silicone gastric banding. Obes Surg. 2000;10(3):214–9.PubMedCrossRef Hell E, et al. Evaluation of health status and quality of life after bariatric surgery: comparison of standard Roux-en-Y gastric bypass, vertical banded gastroplasty and laparoscopic adjustable silicone gastric banding. Obes Surg. 2000;10(3):214–9.PubMedCrossRef
11.
go back to reference Livingston EH. Procedure incidence and in-hospital complication rates of bariatric surgery in the United States. Am J Surg. 2004;188(2):105–10.PubMedCrossRef Livingston EH. Procedure incidence and in-hospital complication rates of bariatric surgery in the United States. Am J Surg. 2004;188(2):105–10.PubMedCrossRef
12.
go back to reference Tice JA, et al. Gastric banding or bypass? a systematic review comparing the two most popular bariatric procedures. Am J Med. 2008;121(10):885–93.PubMedCrossRef Tice JA, et al. Gastric banding or bypass? a systematic review comparing the two most popular bariatric procedures. Am J Med. 2008;121(10):885–93.PubMedCrossRef
13.
go back to reference Encinosa WE, et al. Use and costs of bariatric surgery and prescription weight-loss medications. Health Aff (Millwood). 2005;24(4):1039–46.CrossRef Encinosa WE, et al. Use and costs of bariatric surgery and prescription weight-loss medications. Health Aff (Millwood). 2005;24(4):1039–46.CrossRef
14.
go back to reference Lee WJ, et al. Effects of obesity surgery on the metabolic syndrome. Arch Surg. 2004;139(10):1088–92.PubMedCrossRef Lee WJ, et al. Effects of obesity surgery on the metabolic syndrome. Arch Surg. 2004;139(10):1088–92.PubMedCrossRef
15.
go back to reference Adams TD, et al. Long-term mortality after gastric bypass surgery. N Engl J Med. 2007;357(8):753–61.PubMedCrossRef Adams TD, et al. Long-term mortality after gastric bypass surgery. N Engl J Med. 2007;357(8):753–61.PubMedCrossRef
16.
go back to reference Sjostrom L, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357(8):741–52.PubMedCrossRef Sjostrom L, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357(8):741–52.PubMedCrossRef
17.
go back to reference Kitzinger HB, et al. The prevalence of body contouring surgery after gastric bypass surgery. Obes Surg. 2011. Kitzinger HB, et al. The prevalence of body contouring surgery after gastric bypass surgery. Obes Surg. 2011.
18.
go back to reference Knol JA. Management of the problem patient after bariatric surgery. Gastroenterol Clin N Am. 1994;23(2):345–69. Knol JA. Management of the problem patient after bariatric surgery. Gastroenterol Clin N Am. 1994;23(2):345–69.
19.
go back to reference Kinzl JF, et al. Psychosocial consequences of weight loss following gastric banding for morbid obesity. Obes Surg. 2003;13(1):105–10.PubMedCrossRef Kinzl JF, et al. Psychosocial consequences of weight loss following gastric banding for morbid obesity. Obes Surg. 2003;13(1):105–10.PubMedCrossRef
20.
go back to reference Adami GF, et al. Body image in obese patients before and after stable weight reduction following bariatric surgery. J Psychosom Res. 1999;46(3):275–81.PubMedCrossRef Adami GF, et al. Body image in obese patients before and after stable weight reduction following bariatric surgery. J Psychosom Res. 1999;46(3):275–81.PubMedCrossRef
21.
go back to reference Song AY, et al. Body image and quality of life in post massive weight loss body contouring patients. Obesity (Silver Spring). 2006;14(9):1626–36.CrossRef Song AY, et al. Body image and quality of life in post massive weight loss body contouring patients. Obesity (Silver Spring). 2006;14(9):1626–36.CrossRef
22.
go back to reference Sarwer DB, et al. Psychological considerations of the bariatric surgery patient undergoing body contouring surgery. Plast Reconstr Surg. 2008;121(6):423e–34e.PubMedCrossRef Sarwer DB, et al. Psychological considerations of the bariatric surgery patient undergoing body contouring surgery. Plast Reconstr Surg. 2008;121(6):423e–34e.PubMedCrossRef
23.
go back to reference Oria HE, Moorehead MK. Bariatric analysis and reporting outcome system (BAROS). Obes Surg. 1998;8(5):487–99.PubMedCrossRef Oria HE, Moorehead MK. Bariatric analysis and reporting outcome system (BAROS). Obes Surg. 1998;8(5):487–99.PubMedCrossRef
24.
go back to reference The WHOQOL Group. World Health Organization Quality of Life Assessment. What quality of life? World Health Forum. 1996;17(4):354–6. The WHOQOL Group. World Health Organization Quality of Life Assessment. What quality of life? World Health Forum. 1996;17(4):354–6.
25.
go back to reference Peace K, et al. Psychobiological effects of gastric restriction surgery for morbid obesity. N Z Med J. 1989;102(862):76–8.PubMed Peace K, et al. Psychobiological effects of gastric restriction surgery for morbid obesity. N Z Med J. 1989;102(862):76–8.PubMed
26.
go back to reference Sarwer DB, Fabricatore AN. Psychiatric considerations of the massive weight loss patient. Clin Plast Surg. 2008;35(1):1–10.PubMedCrossRef Sarwer DB, Fabricatore AN. Psychiatric considerations of the massive weight loss patient. Clin Plast Surg. 2008;35(1):1–10.PubMedCrossRef
27.
go back to reference Cintra Jr W, et al. Quality of life after abdominoplasty in women after bariatric surgery. Obes Surg. 2008;18(6):728–32.PubMedCrossRef Cintra Jr W, et al. Quality of life after abdominoplasty in women after bariatric surgery. Obes Surg. 2008;18(6):728–32.PubMedCrossRef
28.
go back to reference Menderes A, et al. Dermalipectomy for body contouring after bariatric surgery in Aegean region of Turkey. Obes Surg. 2003;13(4):637–41.PubMedCrossRef Menderes A, et al. Dermalipectomy for body contouring after bariatric surgery in Aegean region of Turkey. Obes Surg. 2003;13(4):637–41.PubMedCrossRef
29.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
30.
go back to reference Herpertz S, et al. Does obesity surgery improve psychosocial functioning? a systematic review. Int J Obes Relat Metab Disord. 2003;27(11):1300–14.PubMedCrossRef Herpertz S, et al. Does obesity surgery improve psychosocial functioning? a systematic review. Int J Obes Relat Metab Disord. 2003;27(11):1300–14.PubMedCrossRef
31.
go back to reference Hafner RJ, Watts JM, Rogers J. Quality of life after gastric bypass for morbid obesity. Int J Obes. 1991;15(8):555–60.PubMed Hafner RJ, Watts JM, Rogers J. Quality of life after gastric bypass for morbid obesity. Int J Obes. 1991;15(8):555–60.PubMed
32.
go back to reference Rand CS, Kuldau JM, Robbins L. Surgery for obesity and marriage quality. Jama. 1982;247(10):1419–22.PubMedCrossRef Rand CS, Kuldau JM, Robbins L. Surgery for obesity and marriage quality. Jama. 1982;247(10):1419–22.PubMedCrossRef
33.
go back to reference Warner JP, et al. National bariatric surgery and massive weight loss body contouring survey. Plast Reconstr Surg. 2009;124(3):926–33.PubMedCrossRef Warner JP, et al. National bariatric surgery and massive weight loss body contouring survey. Plast Reconstr Surg. 2009;124(3):926–33.PubMedCrossRef
34.
go back to reference Fang J. The cost-effectiveness of bariatric surgery. Am J Gastroenterol. 2003;98(9):2097–8.PubMed Fang J. The cost-effectiveness of bariatric surgery. Am J Gastroenterol. 2003;98(9):2097–8.PubMed
35.
go back to reference Craig BM, Tseng DS. Cost-effectiveness of gastric bypass for severe obesity. Am J Med. 2002;113(6):491–8.PubMedCrossRef Craig BM, Tseng DS. Cost-effectiveness of gastric bypass for severe obesity. Am J Med. 2002;113(6):491–8.PubMedCrossRef
36.
go back to reference Christou NV, et al. Surgery decreases long-term mortality, morbidity, and health care use in morbidly obese patients. Ann Surg. 2004;240(3):416–23. discussion 423–4.PubMedCrossRef Christou NV, et al. Surgery decreases long-term mortality, morbidity, and health care use in morbidly obese patients. Ann Surg. 2004;240(3):416–23. discussion 423–4.PubMedCrossRef
37.
go back to reference Kalarchian MA, et al. Psychiatric disorders among bariatric surgery candidates: relationship to obesity and functional health status. Am J Psychiatry. 2007;164(2):328–34. quiz 374.PubMedCrossRef Kalarchian MA, et al. Psychiatric disorders among bariatric surgery candidates: relationship to obesity and functional health status. Am J Psychiatry. 2007;164(2):328–34. quiz 374.PubMedCrossRef
38.
go back to reference Sjostrom L, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351(26):2683–93.PubMedCrossRef Sjostrom L, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351(26):2683–93.PubMedCrossRef
39.
go back to reference Gusenoff JA, et al. Temporal and demographic factors influencing the desire for plastic surgery after gastric bypass surgery. Plast Reconstr Surg. 2008;121(6):2120–6.PubMedCrossRef Gusenoff JA, et al. Temporal and demographic factors influencing the desire for plastic surgery after gastric bypass surgery. Plast Reconstr Surg. 2008;121(6):2120–6.PubMedCrossRef
Metadata
Title
Plastic Surgery After Gastric Bypass Improves Long-Term Quality of Life
Authors
A. Modarressi
N. Balagué
O. Huber
M. Chilcott
B. Pittet-Cuénod
Publication date
01-01-2013
Publisher
Springer-Verlag
Published in
Obesity Surgery / Issue 1/2013
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-012-0735-8

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