Evaluation of Quality of Life After Bariatric Surgery

Evaluation of Quality of Life After Bariatric Surgery | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Evaluation of Quality of Life After Bariatric Surgery SILVANA LAPI CRUZ, MAURO PERDOMO, GUSTAVO BRUNO, MARISEL BENTANCOR, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8747169/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Morbidly obese people have lower quality of life (QoL) scores than the general population, which improve significantly after surgery. Objective Evaluate the perceived changes in QoL of OMBSP patients, after surgery, according to changes in self-esteem, physical activity, social activity, labor and sexual interest. Design Retrospective observational study of a cohort of patients after one year of bariatric surgery. Material and method Patients belonging to the OBSP were included from January 2016 to January 2022. A computer survey was conducted using the BAROS (Bariatric Analysis and Reporting Outcome System) questionnaire, assessing changes in self-esteem, physical activity, social activity, work and sexual interest. For statistical analysis, the RStudio software was used. Results 114 patients were included, 87.8% women, average age 48 years. 61 sleeve gastrectomies were performed (53.5%) and 53 RYGB (46.5%). 7% postoperative complications. The average BMI changed from 55.8(SD +-14.7) preoperatively to 36(SD+-11) postoperatively. From the results of the BAROS questionnaire, the vast majority have improved their QoL in the five aspects evaluated. 95.6% improved their self-esteem, 95.6% their physical activity, 80.7% improved social life, 78.1% showed improvement in work activity and 61.4% their sexual activity. The average score was 5.31 +/- 2.06. Conclusions Bariatric and metabolic surgery have been shown to be an effective procedure for the treatment of morbid obesity and to determine improvement in QoL. The BAROS score corresponds to a good response to bariatric surgery. General Surgery Gastrointestinal Surgery Drug Discovery, Design, & Development Internal Medicine Quality of life BAROS Bariatric Surgery Background Morbidly obese patients have lower quality of life (QoL) scores than the general population, but these scores after bariatric surgery improve significantly. Weight loss is associated with improvements in functional status and well-being, and the psychological impact and QoL are key outcome measures in these patients. In recent years, there has been increasing interest in assessing health-related QoL as an important part of the comprehensive evaluation of patients. Patient-reported QoL and health status are also long-term predictors of morbidity and mortality. ( 1 ) Objective Evaluate perceived changes in QoL among patients of our Obesity and Metabolic Bariatric Surgery Program (OMBSP) after surgery, according to changes in self-esteem, physical activity, social life, work activity, and sexual interest. Study Design Observational, descriptive, retrospective cohort study of OMBSP patients one year after undergoing their bariatric surgery. Methods Patients included in the OMBSP between January 2016 and January 2022 were analyzed. Inclusion criteria for the program are age between 18 and 65 years, body mass index (BMI) > 40 kg/m2 (or BMI > 35 kg/m2 with comorbidities) and failure of medical-nutritional treatment. Exclusion criteria are addictions (smoking, alcoholism, or drug abuse), uncontrolled psychiatric conditions, lack of family support, or intellectual disability. A computer-based survey was conducted using the Bariatric Analysis and Reporting Outcome System (BAROS) questionnaire (Fig. 1). ( 2 ) The BAROS score comprises three main areas (percentage of excess weight loss(%EWL), changes in medical conditions, and quality of life), each scoring up to 3 points (maximum total 9 points), based on a table that adds or subtracts points. BMI was calculated as weight (kg) divided by height (m 2 ). The percentage of excess BMI loss (%EBMIL) was calculated as ([initial BMI – final BMI] / [initial BMI – 25]) × 100 (3) . Pre-existing medical conditions recorded as comorbidities were hypertension, type 2 diabetes mellitus (T2DM), dyslipidemia and sleep apnea–hypopnea syndrome (OSAHS). Hypertension was defined as a prior diagnosis or meeting the diagnostic criteria of the Joint National Committee (JNC7) ( 4 ) in clinic. A diagnosis of T2DM was made if the patient had a previous diagnosis or meet the American Diabetes Association 2019 criteria in the preoperative evaluation ( 5 ) . Dyslipidemia was defined as a triglyceride level > 150 mg/dL. OSAHS was diagnosed by polysomnography when > 5 events/hour were observed. Remission criteria for the mentioned comorbidities were achieved if improved values were obtained without pharmacological treatment for at least one year: blood pressure < 140/90 mmHg, T2DM remission (HbA1c < 6.5% and fasting glucose < 1.25 g/L) ( 6 ) , triglycerides < 150 mg/dL, and OSAHS remission as ≤ 5 events/hour. Patients received points in BAROS for clinical improvement or resolution of one or more preoperative comorbidities. To assess changes in QoL after treatment, this method incorporates a specifically designed patient questionnaire that addresses: physical activity, social interaction, work performance, sexual interest, and self-esteem. Each item is scored from “very much worse” to “much better.” The sum of the three areas yields the final BAROS score. The result categorizes postoperative QoL as worse, reasonable, good, very good or excellent. The performed surgical procedures were sleeve gastrectomy and standardized Roux-en-Y gastric bypass (RYGB) (100 cm alimentary limb and 100 cm biliopancreatic limb). Statistical analysis was performed using RStudio. Qualitative variables are reported as frequencies and percentages, and quantitative variables with normally distribution as mean ± standard deviation. The median and interquartile range (IQR) are reported for other distributions. Student’s t-test was used for normally distributed quantitative variables and chi-squared test for qualitative variables, with p < 0.005 considered significant. Patient participation was anonymous and data confidentiality was maintained. An independent database with restricted access to the authors was used. The study was conducted under strict ethical standards according to current legislation (Declaration of Helsinki and Uruguayan Decree 158/19). It was registered with the Ministry of Public Health (no. 7082624). Results A total of 114 patients were included (87.8% female), with a median age of 48 years (IQR 21–69 years). Sixty-one patients underwent vertical sleeve gastrectomy (53.5%) and 53 underwent RYGB (46.5%). Postoperative complications occurred in 7% of patients. Mean BMI decreased from 55.8 ± 14.7 preoperatively to 36 ± 11 postoperatively. The %EWL was 51.5% during the first year after surgery. Before surgery, 68.5% of patients had at least one comorbidity; 73% of those patients achieved remission of their comorbidities. In the BAROS QoL assessment, the vast majority of patients showed improvement in all five evaluated aspects. The most improved parameters were self-esteem and physical activity, with 95.6% of the population improving in each. Only 4.38% of patients reported no change in self-esteem. Physical activity worsened in 1.74% and showed no significant change in 2.63%. Social life improved in 80.7% of patients (16.6% saw no change) and work activity improved in 78.1%. Sexual activity showed the least improvement: 31.6% of patients had no improvement and 7% reported worsening of sexual health. All patients whose sexual life worsened were women; among men, 28.6% reported no change. Overall the study population, 61.4% of patients noted improvement in sexual activity. The mean BAROS score was 5.31 ± 2.06, with no statistically significant difference between types of surgery. In total, 84.7% of patients fell into the “very good” to “excellent” response range. Discussion The efficacy of bariatric surgery should be evaluated not only by weight loss and remission of comorbidities, but also by considering complications and the patient’s perception of improved QoL. For this reason, the BAROS questionnaire is widely used to assess bariatric surgery outcomes ( 3 ) . The %EWL is usually higher in the first years after surgery; studies report a mean of 74.6% between 12 and 24 months postoperatively ( 7 ) . Although these values are higher than ours, a general decline is usually observed over time. In our study we also observed improvement in comorbidities, which is consistent with various international cohort studies. Our QoL questionnaire results are excellent: 84.7% of patients had a very good or excellent response to surgery. The most benefited parameters by weight loss were self-esteem and physical activity, each improving in over 90% of patients. Fewer than 5% of the total cohort noted no change in self-esteem or overall condition, and no patient reported rejection of their body image. Notably, more than one-third of patients (37.6%) saw no improvement or a worsening of sexual activity; this may reflect some hesitation in patient responses about this topic. A systematic review by Sierżantowicz et al. (2022) of 18 studies found that QoL after bariatric surgery generally improves during the first 1–2 years postoperatively and then deteriorates. The decline occurs within five and six years after surgery. Despite the reduction in QoL scores observed in 8 out of 10 studies, the scores after 10 years still remain significantly higher than baseline, indicating that bariatric surgery have a persistent beneficial effect on QoL ( 9 ) . A limitation of the QoL questionnaire is that results are influenced by patient subjectivity. This suggests that even smaller weight losses than those traditionally considered optimal may be sufficient to improve some comorbidities and the QoL in our patients. It is noteworthy that our QoL results are comparable with the criteria established by the Spanish Association of Surgeons (AEC), the Spanish Society for Obesity Surgery (SECO), and the American Society for Metabolic and Bariatric Surgery (ASBS) for evaluating bariatric surgery outcomes ( 8 , 9 ) . Conclusions Bariatric and metabolic surgery has been shown to be an effective treatment for morbid obesity ( 10 , 11 ) and for improving QoL, especially in terms of self-esteem and physical activity. The BAROS score in our cohort corresponds to a very good response to bariatric surgery. Declarations All authors in this study declared that they do not have any personal nor financial conflicts of interest. It was approved by the Ethic committee from de Maciel Hospital . References Velásquez JG, Miranda A, Pulgar M, Araujo P, Salazar C (2014) Quality of life assessment in obese patients undergoing bariatric surgery. Rev Ciencias Biomédicas 5(1):79–87. 10.32997/rcb-2014-289 Oria HE, Moorehead MK (1998) Bariatric Analysis and Reporting Outcome System (BAROS). Obes Surg 8(5):487–499. 10.1381/096089298765554043 Junquera S, Ramírez L, Camuñas J, Martín M, Llanos K et al (2021) Quality of life assessment, weight loss, and comorbidity evolution 6 years after bariatric surgery. Endocrinol Diabetes Nutr 68(7):501–508. 10.1016/j.endinu.2020.09.003 Verdecchia P, Angeli F (2003) Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the arsenal is ready. Rev Esp Cardiol 56(9):843–847. 10.1016/S0300-8932(03)76970-X American Diabetes Association (2019) Standards on medical care in diabetes-2019. Diabetes Care 42(1):S1–S193 Brajkovich I, Aschner P, Taboada L, Camperos P, Gómez R, Aure G et al (2019) ALAD consensus: Treatment of patients with type 2 diabetes mellitus and obesity. Rev ALAD 9(Suppl 1):40–75. 10.24875/ALAD.19000369 Queiroz C, Sallet J, Melo P, Pereira de Sousa L, Pimentel J et al (2017 Jan-Mar) Application of BAROS' questionnaire in obese patients undergoing bariatric surgery with 2 years of evolution. Arq Gastroenterol 54(1):60–64. 10.1590/S0004-2803.2017v54n1-12 Sabench Pereferrer F, Domínguez-Adame Lanuza E, Ibarzábal Olano A, Socas Macía M, Valentí Azcárate V, Garcia R, de Gordejuela A et al (2017) Quality criteria in bariatric surgery: an overview and recommendations of the Spanish Association of Surgeons and the Spanish Society for Obesity Surgery. Cir Esp 95(1):4–16 Sierżantowicz R, Kadny JR, Lewko J (2022) Quality of Life after Bariatric Surgery-A Systematic Review. Int J Environ Res Public Health 19(15):9078. 10.3390/ijerph19159078 Sjöström L, Lindroos AK, Peltonen M, Torgerson J, Bouchard C, Carlsson B, Dahlgren S, Larsson B, Narbro K, Sjöström CD, Sullivan M, Wedel H, Swedish Obese Subjects Study Scientific Group (2004) Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med 351(26):2683–2693. 10.1056/NEJMoa035622 Soroceanu RP, TimofteDV, Danila R, Timofeiov S, Livadariu R et al (2023) The impact of bariatric surgery on quality of life in patients with obesity. J Clin Med 12(13):4225. 10.3390/jmc12134225 Additional Declarations The authors declare no competing interests. Supplementary Files ScoreBAROSplanilla.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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life (QoL) scores than the general population, but these scores after bariatric surgery improve significantly. Weight loss is associated with improvements in functional status and well-being, and the psychological impact and QoL are key outcome measures in these patients. In recent years, there has been increasing interest in assessing health-related QoL as an important part of the comprehensive evaluation of patients. Patient-reported QoL and health status are also long-term predictors of morbidity and mortality. \u003csup\u003e(\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e)\u003c/sup\u003e\u003c/p\u003e"},{"header":"Objective","content":"\u003cp\u003eEvaluate perceived changes in QoL among patients of our Obesity and Metabolic Bariatric Surgery Program (OMBSP) after surgery, according to changes in self-esteem, physical activity, social life, work activity, and sexual interest.\u003c/p\u003e "},{"header":"Study Design","content":"\u003cp\u003eObservational, descriptive, retrospective cohort study of OMBSP patients one year after undergoing their bariatric surgery.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003ePatients included in the OMBSP between January 2016 and January 2022 were analyzed.\u003c/p\u003e \u003cp\u003eInclusion criteria for the program are age between 18 and 65 years, body mass index (BMI)\u0026thinsp;\u0026gt;\u0026thinsp;40 kg/m2 (or BMI\u0026thinsp;\u0026gt;\u0026thinsp;35 kg/m2 with comorbidities) and failure of medical-nutritional treatment. Exclusion criteria are addictions (smoking, alcoholism, or drug abuse), uncontrolled psychiatric conditions, lack of family support, or intellectual disability.\u003c/p\u003e \u003cp\u003eA computer-based survey was conducted using the Bariatric Analysis and Reporting Outcome System (BAROS) questionnaire (Fig.\u0026nbsp;1).\u003csup\u003e(\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e)\u003c/sup\u003e The BAROS score comprises three main areas (percentage of excess weight loss(%EWL), changes in medical conditions, and quality of life), each scoring up to 3 points (maximum total 9 points), based on a table that adds or subtracts points. BMI was calculated as weight (kg) divided by height (m\u003csup\u003e2\u003c/sup\u003e). The percentage of excess BMI loss (%EBMIL) was calculated as ([initial BMI \u0026ndash; final BMI] / [initial BMI \u0026ndash; 25]) \u0026times; 100\u003csup\u003e(3)\u003c/sup\u003e. Pre-existing medical conditions recorded as comorbidities were hypertension, type 2 diabetes mellitus (T2DM), dyslipidemia and sleep apnea\u0026ndash;hypopnea syndrome (OSAHS). Hypertension was defined as a prior diagnosis or meeting the diagnostic criteria of the Joint National Committee (JNC7) \u003csup\u003e(\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e)\u003c/sup\u003e in clinic. A diagnosis of T2DM was made if the patient had a previous diagnosis or meet the American Diabetes Association 2019 criteria in the preoperative evaluation \u003csup\u003e(\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e)\u003c/sup\u003e. Dyslipidemia was defined as a triglyceride level\u0026thinsp;\u0026gt;\u0026thinsp;150 mg/dL. OSAHS was diagnosed by polysomnography when \u0026gt;\u0026thinsp;5 events/hour were observed. Remission criteria for the mentioned comorbidities were achieved if improved values were obtained without pharmacological treatment for at least one year: blood pressure\u0026thinsp;\u0026lt;\u0026thinsp;140/90 mmHg, T2DM remission (HbA1c\u0026thinsp;\u0026lt;\u0026thinsp;6.5% and fasting glucose\u0026thinsp;\u0026lt;\u0026thinsp;1.25 g/L) \u003csup\u003e(\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e)\u003c/sup\u003e, triglycerides\u0026thinsp;\u0026lt;\u0026thinsp;150 mg/dL, and OSAHS remission as \u0026le;\u0026thinsp;5 events/hour. Patients received points in BAROS for clinical improvement or resolution of one or more preoperative comorbidities. To assess changes in QoL after treatment, this method incorporates a specifically designed patient questionnaire that addresses: physical activity, social interaction, work performance, sexual interest, and self-esteem. Each item is scored from \u0026ldquo;very much worse\u0026rdquo; to \u0026ldquo;much better.\u0026rdquo; The sum of the three areas yields the final BAROS score. The result categorizes postoperative QoL as worse, reasonable, good, very good or excellent.\u003c/p\u003e \u003cp\u003eThe performed surgical procedures were sleeve gastrectomy and standardized Roux-en-Y gastric bypass (RYGB) (100 cm alimentary limb and 100 cm biliopancreatic limb).\u003c/p\u003e \u003cp\u003eStatistical analysis was performed using RStudio. Qualitative variables are reported as frequencies and percentages, and quantitative variables with normally distribution as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation. The median and interquartile range (IQR) are reported for other distributions. Student\u0026rsquo;s t-test was used for normally distributed quantitative variables and chi-squared test for qualitative variables, with p\u0026thinsp;\u0026lt;\u0026thinsp;0.005 considered significant. Patient participation was anonymous and data confidentiality was maintained. An independent database with restricted access to the authors was used. The study was conducted under strict ethical standards according to current legislation (Declaration of Helsinki and Uruguayan Decree 158/19). It was registered with the Ministry of Public Health (no. 7082624).\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eA total of 114 patients were included (87.8% female), with a median age of 48 years (IQR 21\u0026ndash;69 years). Sixty-one patients underwent vertical sleeve gastrectomy (53.5%) and 53 underwent RYGB\u003c/p\u003e \u003cp\u003e(46.5%). Postoperative complications occurred in 7% of patients. Mean BMI decreased from 55.8\u0026thinsp;\u0026plusmn;\u0026thinsp;14.7 preoperatively to 36\u0026thinsp;\u0026plusmn;\u0026thinsp;11 postoperatively. The %EWL was 51.5% during the first year after surgery. Before surgery, 68.5% of patients had at least one comorbidity; 73% of those patients achieved remission of their comorbidities.\u003c/p\u003e \u003cp\u003eIn the BAROS QoL assessment, the vast majority of patients showed improvement in all five evaluated aspects. The most improved parameters were self-esteem and physical activity, with 95.6% of the population improving in each. Only 4.38% of patients reported no change in self-esteem. Physical activity worsened in 1.74% and showed no significant change in 2.63%. Social life improved in 80.7% of patients (16.6% saw no change) and work activity improved in 78.1%. Sexual activity showed the least improvement: 31.6% of patients had no improvement and 7% reported worsening of sexual health. All patients whose sexual life worsened were women; among men, 28.6% reported no change. Overall the study population, 61.4% of patients noted improvement in sexual activity.\u003c/p\u003e \u003cp\u003eThe mean BAROS score was 5.31\u0026thinsp;\u0026plusmn;\u0026thinsp;2.06, with no statistically significant difference between types of surgery. In total, 84.7% of patients fell into the \u0026ldquo;very good\u0026rdquo; to \u0026ldquo;excellent\u0026rdquo; response range.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe efficacy of bariatric surgery should be evaluated not only by weight loss and remission of comorbidities, but also by considering complications and the patient\u0026rsquo;s perception of improved QoL. For this reason, the BAROS questionnaire is widely used to assess bariatric surgery outcomes\u003csup\u003e(\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e)\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eThe %EWL is usually higher in the first years after surgery; studies report a mean of 74.6% between 12 and 24 months postoperatively\u003csup\u003e(\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e)\u003c/sup\u003e. Although these values are higher than ours, a general decline is usually observed over time.\u003c/p\u003e \u003cp\u003eIn our study we also observed improvement in comorbidities, which is consistent with various international cohort studies.\u003c/p\u003e \u003cp\u003eOur QoL questionnaire results are excellent: 84.7% of patients had a very good or excellent response to surgery. The most benefited parameters by weight loss were self-esteem and physical activity, each improving in over 90% of patients. Fewer than 5% of the total cohort noted no change in self-esteem or overall condition, and no patient reported rejection of their body image. Notably, more than one-third of patients (37.6%) saw no improvement or a worsening of sexual activity; this may reflect some hesitation in patient responses about this topic.\u003c/p\u003e \u003cp\u003eA systematic review by Sierżantowicz et al. (2022) of 18 studies found that QoL after bariatric surgery generally improves during the first 1\u0026ndash;2 years postoperatively and then deteriorates. The decline occurs within five and six years after surgery. Despite the reduction in QoL scores observed in 8 out of 10 studies, the scores after 10 years still remain significantly higher than baseline, indicating that bariatric surgery have a persistent beneficial effect on QoL\u003csup\u003e(\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e)\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eA limitation of the QoL questionnaire is that results are influenced by patient subjectivity. This suggests that even smaller weight losses than those traditionally considered optimal may be sufficient to improve some comorbidities and the QoL in our patients. It is noteworthy that our QoL results are comparable with the criteria established by the Spanish Association of Surgeons (AEC), the Spanish Society for Obesity Surgery (SECO), and the American Society for Metabolic and Bariatric Surgery (ASBS) for evaluating bariatric surgery outcomes\u003csup\u003e(\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e)\u003c/sup\u003e.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eBariatric and metabolic surgery has been shown to be an effective treatment for morbid obesity\u003csup\u003e(\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e)\u003c/sup\u003e and for improving QoL, especially in terms of self-esteem and physical activity. The BAROS score in our cohort corresponds to a very good response to bariatric surgery.\u003c/p\u003e "},{"header":"Declarations","content":"\u003cp\u003eAll authors in this study declared that they do not have any personal nor financial conflicts of interest. It was approved by the Ethic committee from de Maciel Hospital .\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eVel\u0026aacute;squez JG, Miranda A, Pulgar M, Araujo P, Salazar C (2014) Quality of life assessment in obese patients undergoing bariatric surgery. 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Diabetes Care 42(1):S1\u0026ndash;S193\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBrajkovich I, Aschner P, Taboada L, Camperos P, G\u0026oacute;mez R, Aure G et al (2019) ALAD consensus: Treatment of patients with type 2 diabetes mellitus and obesity. Rev ALAD 9(Suppl 1):40\u0026ndash;75. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.24875/ALAD.19000369\u003c/span\u003e\u003cspan address=\"10.24875/ALAD.19000369\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eQueiroz C, Sallet J, Melo P, Pereira de Sousa L, Pimentel J et al (2017 Jan-Mar) Application of BAROS' questionnaire in obese patients undergoing bariatric surgery with 2 years of evolution. 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N Engl J Med 351(26):2683\u0026ndash;2693. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1056/NEJMoa035622\u003c/span\u003e\u003cspan address=\"10.1056/NEJMoa035622\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSoroceanu RP, TimofteDV, Danila R, Timofeiov S, Livadariu R et al (2023) The impact of bariatric surgery on quality of life in patients with obesity. J Clin Med 12(13):4225. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3390/jmc12134225\u003c/span\u003e\u003cspan address=\"10.3390/jmc12134225\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"Maciel Hospital","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Quality of life, BAROS, Bariatric Surgery","lastPublishedDoi":"10.21203/rs.3.rs-8747169/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8747169/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cu\u003e\u003cstrong\u003eBackground\u003c/strong\u003e\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003eMorbidly obese people have lower quality of life (QoL) scores than the general population, which improve significantly after surgery.\u003c/p\u003e\n\u003cp\u003e\u003cu\u003e\u003cstrong\u003eObjective\u003c/strong\u003e\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003eEvaluate the perceived changes in QoL of OMBSP patients, after surgery, according to changes in self-esteem, physical activity, social activity, labor and sexual interest.\u003c/p\u003e\n\u003cp\u003e\u003cu\u003e\u003cstrong\u003eDesign\u003c/strong\u003e\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003eRetrospective observational study of a cohort of patients after one year of bariatric surgery.\u003c/p\u003e\n\u003cp\u003e\u003cu\u003e\u003cstrong\u003eMaterial and method\u003c/strong\u003e\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003ePatients belonging to the OBSP were included from January 2016 to January 2022.\u003c/p\u003e\n\u003cp\u003eA computer survey was conducted using the BAROS (Bariatric Analysis and Reporting Outcome System) questionnaire, assessing changes in self-esteem, physical activity, social activity, work and sexual interest.\u003c/p\u003e\n\u003cp\u003eFor statistical analysis, the RStudio software was used.\u003c/p\u003e\n\u003cp\u003e\u003cu\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003e114 patients were included, 87.8% women, average age 48 years. 61 sleeve gastrectomies were performed (53.5%) and 53 RYGB (46.5%). 7% postoperative complications. The average BMI changed from 55.8(SD +-14.7) preoperatively to 36(SD+-11) postoperatively.\u003c/p\u003e\n\u003cp\u003eFrom the results of the BAROS questionnaire, the vast majority have improved their QoL in the five aspects evaluated. 95.6% improved their self-esteem, 95.6% their physical activity, 80.7% improved social life, 78.1% showed improvement in work activity and 61.4% their sexual activity. The average score was 5.31 +/- 2.06.\u003c/p\u003e\n\u003cp\u003e\u003cu\u003e\u003cstrong\u003eConclusions\u003c/strong\u003e\u003c/u\u003e\u003c/p\u003e\n\u003cp\u003eBariatric and metabolic surgery have been shown to be an effective procedure for the treatment of morbid obesity and to determine improvement in QoL. The BAROS score corresponds to a good response to bariatric surgery.\u003c/p\u003e","manuscriptTitle":"Evaluation of Quality of Life After Bariatric Surgery","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-02-06 03:22:29","doi":"10.21203/rs.3.rs-8747169/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"575798a9-4bc1-48c1-abe7-b3f13dce7ff3","owner":[],"postedDate":"February 6th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":62419779,"name":"General Surgery"},{"id":62419780,"name":"Gastrointestinal Surgery"},{"id":62419781,"name":"Drug Discovery, Design, \u0026 Development"},{"id":62419782,"name":"Internal Medicine"}],"tags":[],"updatedAt":"2026-02-06T03:22:29+00:00","versionOfRecord":[],"versionCreatedAt":"2026-02-06 03:22:29","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8747169","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8747169","identity":"rs-8747169","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}