How Does Bariatric Surgery Affect Pain And Mobility?

Although metabolic benefits are often presented as one of the key benefits of bariatric surgery, in my experience, the benefits to patients in terms of less pain and mobility have always been far more impressive.

Now, a study by Wendy King and colleagues, published in JAMA, confirms these clinical observations in a large cohort of patients undergoing bariatric surgery for severe obesity.

The researchers looked at data from the Longitudinal Assessment of Bariatric Surgery, an ongoing observational cohort study at 10 US hospitals.

Based on results of 2221 participants (89% women, median BMI 46, median age 47), bariatric surgery at 1 year post surgery resulted in a clinically meaningful improvement in 60% of participants for pain, 75% for physical function, and 60% for walk time.

These improvements were largely related to significant reduction in disability related to knee and hip pain.

Nevertheless, the researchers also found that between year 1 and year 3, rates of improvement significantly decreased to 50% for pain and to 70% for physical function, although improvement rates for walk time, knee and hip pain, and knee and hip function were largely sustained.

Variables that appeared to increase the chances of post-surgical benefits included younger age, male sex, higher income, lower BMI, and fewer depressive symptoms presurgery; no diabetes and no venous edema with ulcerations postsurgery (either no history or remission); and presurgery-to-postsurgery reductions in weight and depressive symptoms.

Given that (in contrast to metabolic problems) there are few effective medical treatments for pain and mobility, these “benefits” of bariatric surgery certainly warrant greater attention as it is often these (and not the metabolic problems) that determine the often poor quality of life associated with severe obesity.

@DrSharma
Edmonton, AB