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Bariatric surgery

Change, predictors and correlates of weight- and health-related quality of life in adolescents 2-years following bariatric surgery

International Journal of Obesity volume 44, pages 1467–1478 (2020)Cite this article

Subjects

Abstract

Background/Objectives

Weight-related quality of life (WRQOL) and generic health-related quality of life (HRQOL) have been identified as important patient-reported outcomes for obesity treatment and outcome research. This study evaluated patterns of WRQOL and HRQOL outcomes for adolescents at 24-months post-bariatric surgery relative to a nonsurgical comparator sample of youth with severe obesity, and examined potential weight-based (e.g., BMI, weight dissatisfaction) and psychosocial predictors and correlates of these outcomes.

Subjects/Methods

Multi-site data from 139 adolescents undergoing bariatric surgery (Mage = 16.9; 79.9% female, 66.2% White; MBody Mass Index [BMI] = 51.5 kg/m2) and 83 comparators (Mage = 16.1; 81.9 % female, 54.2% White; MBMI = 46.9 kg/m2) were collected at pre-surgery/baseline, 6-, 12-, and 24-months post-surgery/baseline with high participation rates across time points (>85%). Self-reports with standardized measures of WRQOL/HRQOL as well as predictors/covariates (e.g., weight dissatisfaction, social support, peer victimization, family dysfunction, loss of control eating, self-worth, and internalizing symptoms) were obtained. Growth curve models using structural equation modeling examined WRQOL/HRQOL over time and linear regressions examined predictors and correlates of WRQOL/HRQOL outcomes.

Results

Significant improvement in WRQOL and Physical HRQOL, particularly in the first postoperative year with a leveling off subsequently, was found for the surgical group relative to comparators, but with no significant Mental HRQOL change. At 24 months, the surgical group had significantly greater WRQOL/HRQOL across most subscales. Within the surgical group at 24 months, weight-based variables were significantly associated with WRQOL and Physical HRQOL, but not Mental HRQOL. Mental HRQOL was associated with greater internalizing symptoms and loss of control eating.

Conclusions

For adolescents undergoing bariatric surgery, most clinically meaningful changes in WRQOL and Physical HRQOL occurred early postoperatively, with weight-based variables as the primary drivers of 24-month levels. In contrast, expectations for Mental HRQOL improvement following surgery should be tempered, with 24-month levels significantly associated with psychosocial rather than weight-based correlates.

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Acknowledgements

The authors would like to acknowledge the contributions of additional TeenView and Teen-LABS Study Group Co-Investigators and staff. Cincinnati Children’s Hospital Medical Center: Faye Doland, BS, Ashley Morgenthal, BS, Taylor Howarth, BS, Sara Comstock, MA, April Carr, BS, Lindsey Shaw, MS, Cynthia Spikes, CRC, Shelley Kirk, PhD, Michael Helmrath, MD, PhD, Jane Khoury, PhD; Texas Children’s Hospital, Baylor Medical Center: Margaret Callie Lee, MPH, David Allen, BS, Gia Washington, PhD, Beth Garland, PhD, Mary L. Brandt, MD; University of Pittsburgh Medical Center: Ronette Blake, BS, Nermeen El Nokali, PhD, Silva Arslanian, MD, Anita P. Courcoulas, MD, MPH, Children’s Hospital of Alabama University of Alabama: Krishna Desai, MD, Amy Seay, PhD, Beverly Haynes, BSN, Carroll Harmon, MD, PhD; Nationwide Children’s Hospital Medical Center: Melissa Ginn, BS, Karen Carter, CCRC, Kevin Smith, PhD, Amy E. Baughcum, PhD, Marc P. Michalsky, MD; Teen-LABS Data Coordinating Center: Michelle Starkey Christian, Jennifer Andringa, BS, Carolyn Powers, RD, Rachel Akers, MPH, Tara Schafer-Kalkhoff, MA, CCRP, Jennifer Black, MSSA, LSW, Rosie Miller, RN, CCRC.

Funding

TeenView (R01DK080020; PI: Zeller) was conducted in collaboration with the Teen-LABS Consortium. Teen-LABS was funded by cooperative agreements with the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), through grants: U01DK072493, UM1DK072493, and UM1DK095710 (University of Cincinnati). Dr. Ley and Dr. Kidwell’s effort was supported by an NIH post-doctoral training grant (T32 DK063929).

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Authors and Affiliations

  1. Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Jennifer Reiter-Purtill, Sanita Ley, Katherine M. Kidwell, Todd M. Jenkins & Meg H. Zeller

  2. Texas Children’s Hospital, Houston, TX, USA

    Carmen Mikhail

  3. University of Alabama at Birmingham, Birmingham, AL, USA

    Heather Austin

  4. Nationwide Children’s Hospital Medical Center, Columbus, OH, USA

    Eileen Chaves

  5. University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Dana L. Rofey

  6. Colorado Children’s Hospital, Aurora, CO, USA

    Thomas H. Inge

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  1. Jennifer Reiter-Purtill
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in cooperation with the TeenView Study Group and Teen-LABS Consortium

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Correspondence to Jennifer Reiter-Purtill.

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Conflict of interest

Thomas H Inge has served as a consultant for Zafgen Corporation, Biomedical Insights, and L&E Research, and received honoraria from Standard Bariatrics, UpToDate, and Independent Medical Expert Consulting Services, all unrelated to this project. The remaining authors declare that they have no conflict of interest.

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Reiter-Purtill, J., Ley, S., Kidwell, K.M. et al. Change, predictors and correlates of weight- and health-related quality of life in adolescents 2-years following bariatric surgery. Int J Obes 44, 1467–1478 (2020). https://doi.org/10.1038/s41366-019-0394-0

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