Changes in Health-Related Quality of Life After Metabolic and Bariatric Surgery: A Prospective Single-Center Cohort Study

Objective: Obesity impairs health-related quality-of-life (HRQoL). Substantial weight loss following metabolic and bariatric surgery improves HRQoL, but there is a need for larger long-term studies. This study aimed to examine changes in HRQoL at 2 and 5 years, comparing outcomes between Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG), and to evaluate associations with pre-operative patient characteristics. Methods: HRQoL was assessed using the Short Form-36 (SF-36) questionnaire before surgery and at 2- and 5-year follow-up. Physical and Mental Component Scores (PCS and MCS) were calculated, and associations between baseline characteristics and changes in HRQoL were analyzed. Results: Of 2031 patients, 1285 completed at least one postoperative SF-36. PCS improved significantly at 2 years (mean 9.4, 95% CI 8.7–10.0) and was maintained at 5 years. MCS showed an improvement at 2 years (1.5, 95% CI 0.8–2.2) but not at 5 years. No major differences were found between RYGB and SG, except for lower MCS at 5 years in SG patients (5.2, p = 0.009). Preoperative type 2 diabetes and osteoarthritis were associated with improved HRQoL, whereas psychiatric and gastrointestinal disorders predicted poorer results. Conclusions: Metabolic and bariatric surgery leads to sustained improvements in physical HRQoL, but the response is influenced by preoperative comorbidity.