Evaluation of Quality of Life in Individuals Undergoing Bariatric Surgery

Abstract

Objective: Obesity is a serious health problem facing the world and its incidence has been increasing rapidly in recent years. Obesity surgery is the method applied to patients with severe obesity and comorbidities.In this study, it was aimed to determine the weight loss processes and quality of life (QOL) of individuals who have undergone obesity surgery. Material and Methods: The research is a retrospective, descriptive, cross-sectional study. It was carried out between January and May 2018. The population of the study consisted of 132 people who had obesity surgery between 2012 and February 2015, and the sample consisted of 46 people who had at least two years of obesity surgery and agreed to participate in the study. Data were collected using the "Data Collection Form" and the "SF-36 Quality of Life Scale (QOLS) ". Evaluation of data was analyzed using statistical package program. Results: 80.4% of the participants are women, 69.6% are married, their average age is 43.73+10.54, and 84.8% of them have obese individuals in their families. The participants had a weight problem for an average of 25 years before obesity surgery. At the time of the research, an average of 4.52 +2.00 years had passed since the operation. While 95.7% of the participants were in the third class obese category and 4.3% were in the second class obese category, they had obesity surgery. After two years, 10.9% had reached the third grade category and 13% had reached the second grade category, although only 21.7% had reached normal weight. When the weight perception status of the participants was examined after obesity surgery, 41.3% stated that they reached their ideal weight, 21.7% stated that they reached their ideal weight but regained weight, and 36.9% never reached their ideal weight. It was determined that the participants got 58.26-85.86 points from the sub-dimensions of the QOLS. The QOL score of those who reached their ideal weight were found to be statistically significantly higher than the others (p<0.05). Conclusion: Obesity surgery is a successful operation for weight loss, but it is very difficult for individuals to reach and maintain their normal weight. Those who reach their ideal weight have higher QQL scores than those who cannot reach their ideal weight.

Keywords

• Obesity
• Obesity Surgery
• Quality of Life

Obezite Cerrahisi Geçiren Bireylerde Yaşam Kalitesinin Değerlendirilmesi

Öz

Amaç: Obezite, dünyanın karşı karşıya olduğu ciddi bir sağlık sorunudur ve son yıllarda görülme sıklığı hızla artmaktadır. Obezite cerrahi (OC), ileri derecede obez ve komorbiditeleri olan hastalara uygulanan yöntemdir. Araştırmada OC geçirmiş bireylerin kilo verme süreçleri ve yaşam kalitelerinin (YK) belirlenmesi amaçlanmıştır. Gereç ve Yöntemler: Araştırma retrospektif, tanımlayıcı, kesitsel çalışmadır. Ocak-Mayıs 2018 tarihleri arasında gerçekleştirilmiştir. Araştırmanın evrenini 2012-Şubat 2015 tarihleri arasında OC geçirmiş 132 kişi, örneklemini OC üzerinden en az iki yıl geçmiş ve çalışmaya katılmayı kabul eden 46 kişi oluşturmuştur. Veriler “Veri Toplama Formu” ile “SF-36 Yaşam Kalitesi Ölçeği (YKÖ)” kullanılarak toplanmıştır. Verilerin değerlendirilmesinde istatiksel paket programı kullanılmıştır. Bulgular: Katılımcıların %80,4’ü kadın, %69,6’u evli, yaş ortalamaları 43,73+10,54 ve %84,8’inin ailesinde obez bireyler bulunmaktadır. Katılımcıların cerrahi öncesi ortalama 25 yıldır kilo sorunu bulunmaktadır. Araştırmanın yapıldığı zamanda operasyon üzerinden ortalama 4,52 +2,00 yıl geçmiştir. Katılımcıların %95,7’si üçüncü sınıf, %4,3’ü ikinci sınıf obez kategorisinde iken OC geçirmiştir. İki yıl sonra %10,9’u üçüncü sınıf, %13’ü ikinci sınıf kategoriye ulaşmış olmakla birlikte, sadece %21,7’si normal kiloya ulaşmıştır. Katılımcıların OC sonrası kilo algı durumları incelendiğinde %41,3’ü ideal kilolarına ulaştığını, %21,7’si ideal kilolarına ulaştıklarını ancak yeniden kilo aldıklarını, %36,9’u hiç ideal kilolarına ulaşamadıklarını belirtmişlerdir. Katılımcıların SF-36 YKÖ’nin alt boyutlarından 58,26-85,86 puan aldıkları belirlenmiştir. İdeal kilolarına ulaşanların YKÖ’den aldıkları puan diğerlerinden istatistiksel olarak da anlamlı derecede daha yüksek bulunmuştur (p<0,05). Sonuç: OC kilo vermede başarılı bir operasyondur ancak bireylerin normal kilolarına ulaşmaları ve o kiloda kalabilmeleri oldukça zordur. İdeal kilolarına ulaşanların YKÖ puanları, ideal kilolarına ulaşamayanlara göre daha yüksektir.

Anahtar Kelimeler

• Obezite
• Obezite Cerrahisi
• Yaşam Kalitesi

Kaynakça

1. 1. World Health Organization (WHO). Obesity: preventing and managing the global epidemic Report of a WHO Consultation (WHO Technical Report Series 894). https://www.who.int/nutrition/publications/obesity/WHO_TRS_894/en/. Erişim tarihi: 2.05.2022.
2. 2. Clarke B, Swinburn B, Sacks G. Understanding the LiveLighter® obesity prevention policy processes: An investigation using political science and systems thinking. Social Science and Medicine 2020; 246:1-10.
3. 3. World Health Organization (WHO). Obesity and overweight. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight. Erişim tarihi: 12.05.2022.
4. 4. Türkiye İstatistik Kurumu (TUIK) 2022. Türkiye Sağlık Araştırması. 2019. https://tuikweb.tuik.gov.tr/PreHaberBultenleri.do?id=33661. Erişim tarihi: 30.01.2022.
5. 5. Akkayaoğlu H, Çelik S. Eating attitudes, perceptions of body image and patient quality of life before and after bariatric surgery. Applied Nursing Research 2020; 53:151270.
6. 6. Saka M, Bektaş A. Obezite cerrahi ve beslenme. Güncel Gastroenteroloji 2019; 23:52-5.
7. 7. Kolotkin RL, Gabriel Smolarz B, Meincke HH, Fujioka K. Improvements inhealth-related quality of life over 3 years with liraglutide 3.0 mg compared with placebo in participants with over weight or obesity. Clinical Obesity 2018; 8(1):1–10.
8. 8. Güngör Ş. Obezitenin Tedavisinde Geçmiş ve Güncel Bariatrik Cerrahi Uygulamaları. Muş Alparslan Üniversitesi Fen Bilimleri Dergisi 2019; 7(2):697–705.

9. 9. Chew CAZ, Shabbir A. Revisional Bariatric Surgery: Focus on Quality of Life. Journal of Obesity & Metabolic Syndrome 2017; 26(2): 97–101.
10. 10. Chikunguwo SM, Brethauer SA, Schauer PR. Bariatric surgery: General Surgery. Bland KI (Ed), London, Springer Verlag 2009; 557-66.
11. 11. Douglas TD, Stephens JW, Barry J, Lee MD, Wilkinson LL. The influence of attachment orientation on weight loss, eating behaviour and other health outcomes among patients undergoing bariatric surgery: A scoping review. Appetite 2019; 147:104504.
12. 12. Busetto L, Mozzi E, Schettino AM, Furbetta F, Giardiello C, Micheletto G, Pilone V. Three years durability of the improvements in health-related quality of life observed after gastric banding. Surgery for Obesity and Related Diseases 2015; 11(1):110–17.
13. 13. Yaralı S, Hacıalioğlu N. Obezite Yönetiminde Sağlık İnanç Modelini Kullanma ve Hemşirenin Rolü. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi 2020; 9(4):407–15.
14. 14. Major P, Stefura T, Dziurowicz B, Radwan J, Wysocki M, Malczak P, Pedziwiatr M. Quality of Life 10 Years After Bariatric Surgery. Obesity Surgery 2020; 30:3675–84.
15. 15. Jumbe S, Bartlett C, Jumbe SL, Meyrick J. The effectiveness of bariatric surgery on long term psychosocial quality of life – A systematic review. Obesity Research and Clinical Practice 2016; 10(3):225–42.
16. 16. Yılmaz S, Ferahman S, Aydın H, Karabulut M. Obesity Awareness and Prevalance Study: Patients Admitted to General Surgery Outpatient Clinic. Journal of Ankara University Faculty of Medicine 2020; 73(2):176–82.
17. 17. Kroes M, Osei-Assibey G, Baker-Searle R, Huang J. Impact of weight change on quality of life in adults with overweight/obesity in the United States: A systematic review. Current Medical Research and Opinion 2016; 32(3):485–508.
18. 18. Koçyiğit H, Aydemir Ö, Fişek G, Ölmez N, Memiş, AK. Form-36 (KF-36)’nın Türkçe versiyonunun güvenilirliği ve geçerliliği. İlaç ve tedavi dergisi 1999; 12(2):102-6.
19. 19. Gönenir Erbay L, Akyüz M, Şahin İ, Evren B, Kayaalp C, Karlıdağ R. Bariatrik Cerrahi Adayı Morbid Obezite Hastalarının Yaşam Doyumunun Beden Algısı ve Benlik Saygısı ile İlişkisi. Fırat Tıp Dergisi 2018; 23(1).
20. 20. Kılıç SN. Obezitenin kadınlarda sebep olduğu hormonal bozukluklar ve yol açtığı sorunlar. Sağlık ve Yaşam Bilimleri Dergisi 2020; 2(2):57–65.
21. 21. Kılınç F, Gözel N. Obezite ve genetik. Firat Med J 2018; 23:9–13.
22. 22. Silva JN, Vasconcelos H, Figueiredo-Braga M, Carneiro S. How is bariatric surgery improving the quality of life of obese patients: A Portuguese cross-sectional study. Acta Medica Portuguesa 2018; 31(7–8):391–8.
23. 23. Danışmaz Sevin M, Kaya B, Zengin DB, Esentürk MU, Doğan S, Demir S, Osku S. XXXL bedenler: obez bireylerin başa çıkma stratejilerinin bazı sosyo demografik değişkenler açısından incelenmesi. Toplum ve Sosyal Hizmet 2020; 31(3):1029–52.
24. 24. Yıldız S, Çetinkaya F. Yetişkinlerde Obezite ve Yaşam Kalitesinin Değerlendirilmesi. Ahi Evran Medical Journal 2020; 4(2):29–34.
25. 25. Simonson DC, Halperin F, Foster K, Vernon A, Goldfine AB. Clinical and patient-centered outcomes in obese patients with type 2 diabetes 3 years after randomization to Roux-en-Y gastric bypass surgery versus intensive lifestyle Management: The SLIMM-T2D study. Diabetes Care 2018; 41(4):670–79.
26. 26. Yang P, Chen B, Xiang S, Lin XF, Luo F, Li W. Long-term outcomes of laparoscopic sleeve gastrectomy versus Roux-en-Y gastric bypass for morbid obesity: Results from a meta-analysis of randomized controlled trials. Surgery for Obesity and Related Diseases 2019; 15(4):546–55.
27. 27. Raaijmakers LCH, Pouwels S, Thomassen SEM, Nienhuijs SW. Quality of life and bariatric surgery: A systematic review of short- and long-term results and comparison with community norms. European Journal of Clinical Nutrition 2017; 71(4):441–9.
28. 28. O’Brien PE, Hindle A, Brennan L, Skinner S, Burton P, Smith A, Crosthwaite G, Brown W. Long-Term Outcomes After Bariatric Surgery: a Systematic Review and Meta-analysis of Weight Loss at 10 or More Years for All Bariatric Procedures and a Single-Centre Review of 20-Year Outcomes After Adjustable Gastric Banding. Obesity Surgery 2019; 29:3–14.
29. 29. Yüksel A. Bariatrik Cerrahi Operasyonu Geçiren Morbid Obez Bir Hastanın 3 Yıl Sonraki Beslenme Durumu: Olgu Sunumu. İzmir Katip Çelebi Üniversitesi Sağlık Bilimleri Fakültesi Dergisi 2016; 1(1):39–45.
30. 30. Dizlek D, Çatal E. Morbid Obezitede Bariatrik Cerrahi Sonrası Hasta Sonuçları. Düzce Üniversitesi Bilim ve Teknoloji Dergisi 2018; 6:501–12.
31. 31. Velapati SR, Shah M, Kuchkuntla AR, Abu-dayyeh B, Grothe K, Hurt RT, Mundi MS. Weight Regain After Bariatric Surgery: Prevalence, Etiology, and Treatment. Current Nutrition Reports 2018; 7(4):329–34.
32. 32. Coşkun E, Deveci E, İnce B. Tıkınırcasına Yeme Bozukluğunun OC Tedavi Sürecine Etkisi-Effect of Binge Eating Disorder on the Treatment Process of Bariatric Surgery. Psikiyatride Güncel Yaklaşımlar-Current Approaches in Psychiatry 2020; 12(3):409–20.
33. 33. Kantarovich K, Wnuk S, Cassin S, Hawa R, Sockalingam S. Employment Outcomes 2 Years After Bariatric Surgery: Relationship to Quality of Life and Psychosocial Predictors. Obesity Surgery 2019; 29(9):2854–61.
34. 34. Vander Hofstadt Román CJ, Escribano Cubas S, Tirado González S, Pérez Martínez E, Estrada Caballero JL, Ortiz Sebastián S, Rodríguez-Marín J, Leal Costa C. Changes in quality of life in patients undergoing bariatric surgery following 24-months: comparison between gastric bypass and tubular vertical gastrectomy. bypass and tubular vertical gastrectomy. Anales Del Sistema Sanitario de Navarra 2017; 40(2):199–10.
35. 35. Nickel F, Schmidt L, Bruckner T, Büchler MW, Müller-Stich BP, Fischer L. Influence of bariatric surgery on quality of life, body image, and general self-efficacy within 6 and 24 months-a prospective cohort study. Surgery for Obesity and Related Diseases 2017; 13(2):313–19.
36. 36. Monteiro F, Ponce DAN, Silva H, Pitta F, Carrilho AJF. Physical Function, Quality of Life, and Energy Expenditure During Activities of Daily Living in Obese, Post-Bariatric Surgery, and Healthy Subjects. Obesity Surgery 2017; 27(8):2138–44.
37. 37. Üstün I, Solmaz A, Gülçiçek OB, Kara S, Albayrak R. Effects of bariatric surgery on knee osteoarthritis, knee pain and quality of life in female patients. Journal of Musculoskeletal Neuronal Interactions 2019; 19(4):465–71.
38. 38. Pandey A, Kulshrestha S, Masood S, Chauhan S. Effect of Bariatric Surgery on Psychosomatic Condition and Quality of Life of Patients with Morbid Obesity: A Study. The International Journal of Indian Psychology 2017; 4(3):111-7.
39. 39. Warkentin LM, Majumdar SR, Johnson JA, Agborsangaya CB, Rueda-Clausen CF, Sharma AM, Klarenbach SW, Karmali S, Birch DW, Padwal RS. Weight loss required by the severely obese to achieve clinically important differences in health-related quality of life: two-year prospective cohort study. BMC Medicine 2014; 12(175):1-9.
40. 40. Modesitt SC, Hallowell PT, Slack-Davis JK, Michalek RD, Atkins KA, Kelley SL, Arapovic S, Shupnik MA, Hoehn K. Women at extreme risk for obesity-related carcinogenesis: Baseline endometrial pathology and impact of bariatric surgery on weight, metabolic profiles and quality of life. Gynecologic Oncology 2015; 138(2):238–45.
41. 41. Sarwer DB, Wadden TA, Moore RH, Eisenberg MH, Raper SE, Williams NN. Changes in quality of life and body image after gastric bypass surgery. Surgery for Obesity and Related Diseases 2010; 6(6):608–14.