Determinants of health-related quality of life in morbid obese candidates to gastric banding

Objective. To analyse determinants of self reported health-related quality of life (HRQoL) in morbid obese patients candidates to laparoscopic adjustable gastric banding (LAGB). Methods. Determinants of HR-QoL were investigated in 383 morbid obese patients (82 M and 301 F) with BMI≥40 kg/m2 (BMI≥35 kg/m2 if complicated obesity) and age 18-60 years. HR-QoL was determined with the SF-36 questionnaire. Determinants of the two summary measures of SF-36 (physical component and mental compoment) were analysed by stepwise multiple linear regression analysis with age, BMI, physical comorbidites, mental comorbidites and eating behaviour disorders as independent variables. Physical comorbities (diabetes, hypertension, hypertriglyceridemia, low HDL, sleep apnea and osteoarthritis) were coded as present or absent on the basis of simple diagnostic clinical criteria. Mental comorbidities (depression) and eating behaviour disorders (binge eating, sweet eating and nibbling) on the basis of a unstructured clinical interview. Results. Mean age was 38.8±10.2 years and mean BMI was 41.5±5.4 kg/m2. Scores in the 8 SF-36 subscales were lower in women than in men and lower than in the general Italian population. However, 18.4-43.5% of the participants had HR-QoL levels above the normative values, but 12 to 43% of them, depending on the scale. In both genders, low scores in the mental component of the SF-36 were associated to the presence of depression and eating behaviour disorders and not to physical comorbidities or BMI levels. Low physical self-perceived well being was associated to high BMI levels in men and to depression, hypertension and hypertriglyceridemia in women. Conclusion. HR-QoL was poor in morbid obese candidates to LAGB, particularly in women, and was negatively affected more by mental comorbidites and eating behaviour disorders than by physical comorbidities or BMI levels.