10.1002/9781118797914

Vollständiger Abstract

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<h4>Background</h4>Obesity and Type 2 diabetes (T2D) impair health-related quality of life (HRQoL) across metabolic, mechanical and mental domains. Gastric bypass surgery improves HRQoL in the short term, but long-term trajectories remain insufficiently understood. This study evaluated HRQoL 8 years after gastric bypass in a cohort with T2D, integrating quantitative assessments with qualitative exploration of lived experiences.<h4>Methods</h4>Eleven individuals with obesity and T2D who underwent gastric bypass participated in an 8-year follow-up. Anthropometric and clinical data were collected. HRQoL was assessed using the RAND SF-36, and changes over time were analyzed using repeated-measures ANOVA. Correlations between changes in BMI, HbA1c and HRQoL domains were assessed with Spearman correlations. Semi-structured qualitative interviews were conducted, transcribed verbatim and analyzed using reflexive thematic analysis.<h4>Results</h4>Participants experienced modest weight regain but significant deterioration in glucose control from the 2-year to the 8-year follow-up. RAND SF-36 scores returned to preoperative levels, and the mental health score was significantly reduced compared to the 2-year follow-up (q < 0.01). Weight regain correlated with reduced physical functioning, role-physical and vitality scores (all r < -0.7, p < 0.05), while HbA1c increase correlated with poorer mental health and role-emotional scores (all r < -0.6, p < 0.05). Qualitative interviews revealed that long-term HRQoL was dynamic and shaped by an interplay of physical functioning, psychological wellbeing, body adaptations, social support and life events. An overarching theme emerged: Quality of life after gastric bypass is a multidimensional, evolving process influenced by changing health, life circumstances and psychosocial factors over time.<h4>Conclusions</h4>Initial postoperative improvements in HRQoL were not sustained at 8 years and might have been influenced by weight regain, T2D relapse and intercurrent illness. However, lived experiences highlighted meaningful and durable benefits in physical functioning and self-perception for several participants. The findings underscore the need for long-term, holistic follow-up that integrates metabolic monitoring with psychological and social support.<h4>Trial registration</h4>ClinicalTrials.gov registration: NCT02729246.

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