The Effect of Bariatric Surgery on Quality of Life and Depression

Objective: To assess the effect of bariatric surgery (BS) on health-related quality of life (HRQoL) and depressive symptoms in adolescents in a randomized controlled trial, comparing laparascopic adjustable gastric banding (LAGB) with multidisciplinary lifestyle intervention (MLI) to MLI alone. Method: Adolescents with severe obesity were referred to our study after failure of conservative therapy and randomized into the intervention group (LAGB and MLI) or the control group (MLI). Anthropometric measurements, questionnaires evaluating HRQoL, and depressive symptoms were taken at baseline, 12 months, and 24 months. Results: Significant differences between the study groups in body mass index (BMI), HRQoL, and depressive symptoms at 12 months were observed. After 24 months, this difference persisted for BMI (mean difference −3.43, 95% CI −6.78, −0.80) and BMI z score (−0.45, 95% CI −0.75, −0.14) but not for HRQoL (7.80, 95% CI −1.93, 17.53) and depressive symptoms (−4.18, 95% CI −11.68, 3.31). Conclusion: BS combined with MLI was superior in comparison to MLI alone to reduce BMI and to mediate improvement in HRQoL and self-reported depression after 12 months. However, only the difference in BMI was sustained after 24 months. This indicates that LAGB in combination with MLI does not show superiority over MLI alone for the improvement in HRQoL and depressive symptoms in adolescents with severe obesity over 2 years. Plain language summary: Bariatric surgery is increasingly performed in adolescents with severe obesity. In our randomized controlled trial, the authors compared the effects of two treatment approaches on health-related quality of life and depressive symptoms: bariatric surgery using laparoscopic adjustable gastric banding combined with multidisciplinary lifestyle intervention versus multidisciplinary lifestyle intervention alone. Over a two-year period, the authors found that laparoscopic adjustable gastric banding combined with multidisciplinary lifestyle intervention did not show superiority over multidisciplinary lifestyle intervention alone for the improvement of health-related quality of life and depressive symptoms. Clinical Trial Registration Information: Bariatric surgery versus conservative treatment in morbidly obese children; https://onderzoekmetmensen.nl/en/node/47066/pdf