SWEDISH OBESE SUBJECTS (SOS) - AN INTERVENTION STUDY OF OBESITY - 2-YEAR FOLLOW-UP OF HEALTH-RELATED QUALITY-OF-LIFE (HRQL) AND EATING BEHAVIOR AFTER GASTRIC-SURGERY FOR SEVERE OBESITY

OBJECTIVE: To examine the effects of weight loss on health-related qua lity of life (HRQL) in subjects with severe obesity. DESIGN: Controlle d clinical trial of the outcomes of surgical vs conventional weight re duction treatment. SUBJECTS: The first 487 surgical cases and their co nventionally treated, matched controls were followed for two years in the Swedish Obese Subjects (SOS) intervention study. MEASUREMENTS: A b attery of generic and study-specific self-assessment instruments or su bscales was used to characterize HRQL in the severely obese (BMI) grea ter than or equal to 34 kg/m(2) for males and BMI greater than or equa l to 38 kg/m(2) for females). Measures of general health perceptions ( general health rating index; current health), mental well-being (mood adjective check list; pleasantness, activation and calmness), mood dis orders (hospital anxiety and depression scale; anxiety and depression) and social interaction (sickness impact profile), were supplemented b y obesity-specific modules on obesity-related psychosocial problems an d eating behavior (three-factor eating questionnaire; restrained eatin g, disinhibition and perceived hunger). Assessments were conducted pri or to treatment and repeated after 6, 12 and 24 months. RESULTS: Poor HRQL before intervention was dramatically improved after gastric restr iction surgery, while only minor fluctuations in HRQL scores were obse rved in the conventionally treated controls. Peak values were observed in the surgical group at 6 or 12 months after intervention with a sli ght to moderate decrease at the two-year follow-up. The positive chang es in HRQL after two years were related to the magnitude of weight los s, that is, the greater the weight reduction, the greater the HRQL imp rovements, Eating behavior improved accordingly. CONCLUSION: Quality o f life in the severely obese is improved by substantial weight loss, M ost patients benefit from weight reduction surgery, while HRQL in surg ical patients with minor reduction in overweight is less positive. Fur ther research is needed to determine outcome predictors of the surgica l management of severe obesity and to ensure that HRQL improvements ar e maintained.