Background: There is uncertainty regarding the selection of obese patients for metabolic procedures, how to define a successful outcome and pre-operative predictors of success. Our aim was to explore the influence of obesity on preoperative quality of life in patients awaiting bariatric surgery.
Methods: Pre-operative data were accrued for morbidly obese patients (n=70) at the University Hospitals Coventry and Warwickshire (UHCW) during the last 2 years, and for whom funding for metabolic surgery had been secured. Baseline pre-operative assessment details including clinico-demographic data and where available, IWQOL-Lite questionnaire (a validated self-reported 31-item measure of physical function, self-esteem, sexual life, public distress and work related domains of obesity-specific quality Of life (QOL)) scores transformed to a 0 to 100 scale, where a score of 100 represents the best Health-Related QOL (HRQOL), were obtained. The impact of BMI on each QOL measure was analysed through bivariate Pearson correlations and through comparisons between two sub-groups based on body mass index (BMI): 40-49.9 kg/m2 and ≥60 kg/m2. Results are reported as (mean) and (S.D.). P<0.05 is considered statistically significant.
Results: The lower BMI (n=30) and higher BMI (n=12) sub-groups had no significant differences in age and sex distribution. Comparisons between the lower and higher BMI sub-groups showed significant difference in public distress HRQOL alone (34.6 (27.2) vs 14.5 (21.8) respectively; P=0.03). Bivariate analyses showed significant negative linear correlation only between BMI and public distress HRQOL (r=−0.341, P=0.002). On multivariate linear regression analysis with BMI, age and sex as independent variables and HRQOL scores as dependent variables, the impact of BMI on public distress was significant (B=−1.339, P=0.002).
Conclusion: BMI appears to influence all domains of QOL in a negative linear fashion but is only significant for public distress HRQOL. Improvements of HRQOL measures should feature in the definition of a successful metabolic surgical outcome.