Comparison of the Moorehead-Ardelt quality of life questionnaire and the BODY-Q in Danish patients undergoing weight loss and body contouring surgery

VALIDITY OF THE BRAZILIAN-PORTUGUESE VERSION OF MOOREHEAD-ARDELT QUALITY OF LIFE QUESTIONNAIRE II AMONG PATIENTS WITH SEVERE OBESITY

BACKGROUND

Patients with obesity present multiple comorbid psychiatric conditions and experience impairments in health-related quality of life. Reliable and valid tools that evaluate health-related quality of life are essential for clinical practice.

AIMS

This study aimed to investigate the reliability and validity of the six-item Moorehead-Ardelt Quality of Life Questionnaire II among Brazilian patients with severe obesity.

METHODS

We assessed 387 patients (mean age 43 years, 78.8% women, mean body mass index of 46.5 kg/m²) on the waiting list of a bariatric surgery center. Trained research assistants concurrently applied the Moorehead-Ardelt Quality of Life-II, the Montgomery-Åsberg Depression Rating Scale, and the Global Assessment of Functioning for assessing health-related quality of life, comorbid depressive symptoms, and patient functioning level, respectively.

RESULTS

The internal consistency of the Moorehead-Ardelt Quality of Life-II was considered acceptable. The total score was correlated with the severity of depressive symptoms and functioning level. The more body mass index increases, the more health-related quality of life worsens. The Moorehead-Ardelt Quality of Life-II presented a unidimensional structure.

CONCLUSIONS

The unidimensional Moorehead-Ardelt Quality of Life-II is a reliable and valid measure for evaluating health-related quality of life in Brazilian patients with severe obesity. The questionnaire allows to quickly assess the health-related quality of life of patients in different bariatric contexts, considering depression and functional level.

Depressive symptoms and quality of life prior to metabolic surgery in Cape Town, South Africa

Background

Depression has been shown to have a negative impact on the outcomes of metabolic surgery and quality of life (QOL). Currently, there are limited data on mental distress and QOL in metabolic surgery candidates in South Africa.

Aim

This study aimed to determine the prevalence of depressive symptoms at the time of presurgical assessment in participants undergoing metabolic surgery.

Setting

The Obesity and Metabolic Surgery Initiative at Tygerberg Hospital.

Methods

We conducted pre-operatively a retrospective cross-sectional study on patients who underwent metabolic surgery from September 2017 to September 2019. Participants were profiled in terms of metabolic parameters, depressive symptoms and QOL.

Results

Of the 157 participants assessed, 88% were female with a body mass index in the super obese range. Twenty-two percent of participants had depressive symptoms. Metabolic surgery candidates with depressive symptoms had a significantly poorer overall QOL score compared with those without depressive symptoms. When controlling for all other variables, an increase in QOL score was shown to decrease the odds of current depressive symptoms, whilst back pain on non-narcotic medication and having had a stroke were found to increase the odds of current depressive symptoms.

Conclusion

This study highlights the complex interplay between metabolic, clinical and psychiatric factors in patients undergoing metabolic surgery. The study highlights the vital role of a psychiatrist as part of a multidisciplinary team pre- and post-operatively in the early identification of depressive symptoms. Psychiatrists may have an important role to play as part of the multidisciplinary team in metabolic surgery, including screening for mental health problems pre- and post-operatively, providing psychoeducation and relevant pharmacological treatment and psychotherapy where needed.

Contribution

This study expands our limited knowledge of psychiatric comorbidity (in particular depressive symptoms and associated factors) in people undergoing metabolic surgery in low- and middle-income countries.

The impact of body mass index (BMI) on satisfaction with work life: An international BODY-Q study

Obesity is a global health issue known to have a major influence on health-related quality of life (HR-QOL). HR-QOL is a concept evaluating physical and psychological health. Work life can impact HR-QOL in people with obesity. The aim of this study was to measure the association between body mass index (BMI) and satisfaction with work life. This study included participants from an international multicenter field-test study of BODY-Q scales. Recruitment took place at hospitals in Denmark, The Netherlands and USA between June 2019 and January 2020. The BODY-Q Work Life scale was used to measure work life satisfaction. The difference between BMI groups and work life satisfaction was examined using one-way analysis of variance. Multivariable linear regression analysis was used to examine the association between BMI and work life satisfaction, adjusted for significant confounders. Of 4123 participants, 2515 completed the BODY-Q Work Life scale. BMI groups showed significant difference in work life satisfaction (p < .0001). The Work Life scale mean score was 77.6 for the normal BMI group, 78.5 for the overweight group and 75.0, 68.9 and 63.8 for Class 1, 2 and 3 obesity, respectively. Furthermore, BMI was significantly associated with satisfaction with work life (adjusted regression coefficient -.962, p < .0001). Higher BMI was associated with lower work life satisfaction. This finding suggests that a reduction in BMI may have a positive influence on work life satisfaction in people with obesity.

Medial Thighplasty Improves Patient's Quality of Life After Massive Weight Loss: a Prospective Multicentric Study

BACKGROUND

The aim of this study was to assess the impact of medial thighplasty following massive weight loss on the quality of life of patients and on their sexual life.

METHODS

We performed a multicentric, prospective study on the quality of life after massive weight loss using the Short-Form 36 questionnaire, the Female Sexual Function Index questionnaire, and the Moorehead-Ardelt Quality of life questionnaire. Forty-nine patients who underwent medial thighplasty were included in three centers and evaluation was made pre- and post-operatively.

RESULTS

The mean age of the patients was 44 ± 12.5 years. The average pre-medial thighplasty body mass index was 27 ± 3.8 kg/m2. All the categories of the SF36 questionnaire scored higher after surgery apart from "health change" but only the "role limitations due to emotional problems" category was significantly improved (p = 0.0081). Similarly, the Moorehead-Ardelt questionnaire showed a positive impact of the surgery on the quality of life in general (mean total score 1.04 ± 1.37) and on self-esteem, physical activity, social relationships, and work performance. Interestingly, sexual activity was not improved by the surgery and this result is in line with the FSFI, which showed no effect of medial thighplasty on sexual life.

CONCLUSIONS

Medial thighplasty improves the quality of life of patients after massive weight loss but does not seem to modify the sexual quality of life. These results clearly indicate that this surgery should be widely offered to patients seeking reconstruction of massive weight sequelae.

The postpartum abdomen: psychology, surgery and quality of life

PURPOSE

The postpartum abdomen presents significant challenges to the surgeon. It is anatomically complex, with often substantial symptomatic divarication of the rectus abdominis, affecting all anterior abdominal wall layers. This may lead to profound functional sequelae, and often, of more importance to patients, a significant physical deformity. The complex interplay of functional/physical symptoms can result in reduced quality of life (QoL) as well as negative body image/self-esteem. Postpartum women may seek abdominoplasty to address the whole scope of these concerns. Whilst techniques have evolved achieving such goals operatively, the impact of such surgery on QoL/mental health has yet to be established.

METHODS

We perform a comprehensive review of potential options of validated patient-reported outcome measures (PROMs) for consideration of use in postpartum women seeking abdominoplasty; in addition to discussing current driving factors for seeking surgery and associated ethics.

RESULTS

Pressure on postpartum women to return their abdominal wall contour to a pre-pregnant state is high. This poses important ethical considerations for surgeons. There are several well-established/validated PROMs used in body contouring in massive weight loss/bariatric population groups, including Body-Q and Body-QoL scales, but none yet specific to postpartum women.

CONCLUSION

PROMs use to enable establishment of the true value of abdominoplasty in postpartum women, not just in terms of functional/physical restoration, but also in terms of delivering a positive impact on patients' mental health and QoL, are important. Further research is needed to determine if those already developed are appropriate or whether a postpartum-specific PROM would be beneficial.

The long-term effect of body contouring procedures on the quality of life in morbidly obese patients after bariatric surgery

Introduction

There has been a significant increase in the number of body contouring procedures performed worldwide. This study aimed to evaluate the long-term psychosocial effects of these procedures among patients who undergone weight loss surgery and maintained their body mass for a minimum of one year.

Material and methods

Post-bariatric patients undergoing body contouring procedures were recruited for the study consecutively. Inclusion criteria: BMI < 30 following bariatric surgery, weight maintenance for a minimum of 12 months, and completion of all follow up questionnaires (6 and 12 months). Patients were surveyed 24 hours before, 6-months, and 12-months post-procedure using a Polish validated version of BODY-Q.

Results

30 consecutive patients with a mean age of 38 years (SD 5,91) were included in this study. The BODY-Q questionnaire revealed statistically significant improvements in the acceptance of body appearance after 12 months of follow up. In the abdominal area, the rise in scores achieved 90 from the starting level of 13, and the overall body image increased from 24 to 67. Moreover, in patients with postoperative complications (one hematoma and four minor wound dehiscence), the overall score did not differ from uncomplicated patients.

Conclusions

Body contouring procedures after massive weight loss significantly improve the general perception of personal appearance as well as both the psychological and social aspects of life in patients, already significantly stigmatized by their appearance. Body contouring procedures have essential value and should be widely offered as a step in the treatment of morbidly obese patients.