Bariatric surgery improves household independence for 20 years

People who undergo bariatric surgery and see substantial weight loss are better able to cope with household tasks such as cleaning, laundry, and grocery shopping. The improvements are also sustained over a long time, according to a study at the University of Gothenburg. The research is based on data from the Swedish Obese Subjects (SOS) study at the University of Gothenburg, the world's most comprehensive study on the long-term effects of bariatric surgery compared to conventional obesity treatment.

Previous research has shown that bariatric surgery can reduce the risk of conditions such as type 2 diabetes, cardiovascular disease, and certain cancers. This present study highlights another important consideration: the impact of treatment on people's daily lives and their ability to live independently.

Although it is well known that obesity negatively affects quality of life, with a reduced ability to perform daily tasks, the impact that substantial weight loss after bariatric surgery has on people's home life has not been well studied.

The study involved over 3,200 people with obesity and compared patients who had undergone bariatric surgery with those who received standard obesity care without surgery. The study participants were asked to rate their ability to manage everyday tasks in the home, such as cleaning, laundry, grocery shopping, gardening, and household finances.

The ability to perform household tasks was assessed using the standardised Home Management category of the Sickness Impact Profile (SIP) scale in 1641 bariatric surgery patients and 1656 usual obesity care controls from the Swedish Obese Subjects study. Assessments were conducted at baseline and multiple follow-ups over a 20-year period. Patients (aged 37–60 years, BMI ≥ 34 kg/m2 for men and ≥ 38 kg/m2 for women) were recruited between 1987 and 2001. Analyses were adjusted for sex, and baseline age, BMI, cohabitation status, and weekly working hours as well as year of study inclusion.

At baseline, the score of the Home Management category of the SIP scale was higher in the surgery group than in controls, indicating greater home management dysfunction. Within the first year, however, the surgery group showed significant improvement, attaining a lower score than the control group (4.9 ± 12.4 vs. 7.0 ± 14.1; p<0.001). This improvement persisted throughout 20 years of follow-up, with an adjusted score difference of − 3.2 (95% CI: − 3.9 to − 2.6; p<0.001).

Dysfunction in home management followed similar trajectories over time in both sexes but women consistently reported greater dysfunction than men. In the surgery group, individuals who regained weight reported significantly higher dysfunction in home management during 20 years of follow-up than those who maintained weight (adjusted score difference 1.3, 95% CI: 0.2 to 2.4; p=0.020).

The results show that the patients who underwent surgery experienced distinct improvements within one year of surgery, linked to increased mobility and better general health. The higher functional capacity then persisted throughout the 20-year follow-up period.

"The study indicates that significant and sustained weight loss not only improves medical risk factors and longevity but also people's practical everyday functioning and independence," states Professor Per-Arne Svensson from the University of Gothenburg, lead author of the study.

The researchers also found that patients who regained much of the lost weight reported poorer functioning over time than people who maintained the weight loss. The results underline the importance of long-term weight stability after obesity treatment.

The participants in the study were aged 37–60 at the start of the study. The men had a BMI value of 34 or more, and the women 38 or more. 1,641 of the participants underwent bariatric surgery, while 1,656 received standard obesity care.

The findings were reported I the paper, ‘Association between bariatric surgery and long-term ability to perform household tasks in the Swedish Obese Subjects study: a controlled prospective cohort study’, published in BMC Medicine.

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