Elsevier

Surgery for Obesity and Related Diseases

Volume 4, Issue 5, September–October 2008, Pages 651-658
Surgery for Obesity and Related Diseases

Allied health article
Health and health-related quality of life: differences between men and women who seek gastric bypass surgery

https://doi.org/10.1016/j.soard.2008.04.012Get rights and content

Abstract

Background

The aim of this study was to examine the differences between male and female bariatric surgery candidates with respect to health-related quality of life (HRQOL), health, sociodemographic variables, and interactions among these variables in a bariatric surgery practice in the United States. Women seek bariatric surgery 5 times more often than men. Research on gender differences in HRQOL is limited, and the results are conflicting.

Methods

A total of 794 surgery candidates (mean age 42.2 y; body mass index 46.9 kg/m2; 84.8% women) completed both a weight-related (Impact of Weight on Quality of Life-Lite questionnaire) and a generic (Medical Outcomes Study Short-Form-36) measure of HRQOL. Health was evaluated by questionnaire and clinical interviews.

Results

Compared to men, women reported reduced HRQOL on 3 of the 5 scales assessing obesity-specific HRQOL and also the physical aspects of general HRQOL. Women also had double the rate of depression (48.5% versus 22.5%), and men had double the rate of sleep apnea (80.3% versus 40.2%). Women were younger, less obese, and were less likely to be married. No gender differences were found in the association between HRQOL and co-morbidities. However, an increasing number of co-morbidities was associated with decreasing physical and mental HRQOL. Additionally, depression was associated with decreased mental HRQOL, and coronary heart disease was associated with decreased physical HRQOL.

Conclusion

Women's reduced HRQOL, particularly in self-esteem, sexual life, and physical functioning, and their greater rates of depression, might play a role in their decision to seek bariatric surgery. Although we could not determine causality, this study is a first step toward understanding why women seek surgery 5 times more often than men.

Section snippets

Participants

The sample for the present study consisted of 794 gastric bypass surgery patients recruited from a bariatric surgery practice in Utah for a 2-year prospective study [15]. The exclusion criteria for the study were as follows: previous weight loss surgery, gastric or duodenal ulcers within the previous 6 months, active cancer (with the exception of nonmelanoma skin cancer), alcohol or narcotic abuse, and myocardial infarction within the previous 6 months.

Procedures

The University of Utah institutional

Sociodemographic and weight characteristics

The present sample consisted of 674 women (mean age 41.7 y, range 19-70) and 120 men (mean age 45.1 y, range 18-71). The sociodemographic and weight characteristics by gender are presented in Table 1. Women had a significantly lower BMI (P = .013), were on average younger (P <.001), and were less likely than men to be married (69% versus 56%, respectively). Men and women did not differ significantly in terms of education or ethnicity.

Preoperative co-morbid conditions

Table 2 lists the rates of co-morbidities by gender. Women

Discussion

Consistent with the published bariatric surgery data [2], this sample of individuals seeking gastric bypass surgery was predominantly women (84.8%). A key aim of this research was to add to our understanding of why women are 5 times more likely to undergo bariatric surgery. From the results of this study, several differences were observed between men and women with respect to HRQOL, health, and sociodemographic variables. Specifically, women had reduced HRQOL compared with men on 3 of the 5

Conclusion

The results of this study of bariatric surgery patients found important differences between men and women with respect to preoperative HRQOL, health, and sociodemographic variables. Women's HRQOL was impaired relative to men's, particularly in the areas of self-esteem, sexual life, work, and general physical HRQOL Women also experienced double the rate of depression, and men experienced double the rate of sleep apnea. Women in this study also tended to be younger and less obese and were less

Disclosures

R. L. Kolotkin received compensation in her role as consultant for the grant, and she received royalties from Duke University for use of the IWQOL-Lite questionnaire.

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    Supported by a grant from the National Institute of Arthritis, Diabetes, Digestive and Kidney Diseases (“Morbidity and Mortality Related to Gastric Bypass Surgery” R01 DK055006-06A1).

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    Copyright © 2008 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.