Predictors of Health-Related Quality of Life After Bariatric Surgery.

BACKGROUND: Bariatric surgery is typically associated with improvement in health-related quality of life (HRQoL). However, recent reports are conflicting, and the aim of this study was to determine factors that would be predictive for long-term outcomes after bariatric procedures. METHODS: One thousand five hundred and seventy-three patients at one Midwestern academic medical center who underwent any type of bariatric surgery were sent the SF-36 survey. Three hundred and fifty completed surveys collected over a 3-month period were returned. Multivariate analysis was conducted. RESULTS: The physical and mental component scores were significantly lower than the norm population mean. Age at time of surgery, pre-surgical body mass index (BMI) and duration since surgery were negatively related to HRQoL. CONCLUSIONS: Improvements in HRQoL following bariatric surgery do not appear to be sustained over the long term. Older patients and those with high pre-surgical obesity do not appear to have the same benefits in HRQoL over time.

Obesity bias in primary care providers.

BACKGROUND AND OBJECTIVES: At the forefront of the obesity epidemic, obesity bias is an under-recognized and widely prevalent barrier to optimal care of the obese patient, even among primary care professionals. Recommendations for the reduction of obesity bias include increasing provider awareness about the complex etiology of obesity and the difficulties obtaining sustainable weight loss. METHODS: Obesity bias was measured in primary care professionals (n=233) participating in a continuing education program, using the Anti-Fat Attitudes Questionnaire (AFAQ). Three sub-factors, "Fear of Fat," "Willpower," and "Dislike," were evaluated. Participants were divided into three primary care experience groups: least experienced (0--9 years, n=67), moderately experienced (10--19 years, n=49), and most experienced (20+ years, n=98). "Fear of Fat" and "Willpower" components were found to be more prevalent than "Dislike"; however, scores on the "Dislike" subscale were highest and significantly more prevalent in the group with the most experience. RESULTS: Results indicated that more experienced primary care professionals reported greater bias toward obese people than less experienced colleagues. CONCLUSIONS: Ongoing continuing education that recognizes the wide prevalence of obesity, encourages respect for people of size, and mitigates obesity stigma should be promoted for all providers, particularly those who have been in practice for many years.