Qualitative and Quantitative Health‐Related Quality‐of‐Life Outcomes From an 8‐year Follow‐Up After Gastric Bypass Surgery in People With Type 2 Diabetes
Giovanni Fanni, Petros Katsogiannos, Magnus Sundbom, Janeth Leksell, Eva RandellABSTRACT
Background
Obesity and Type 2 diabetes (T2D) impair health‐related quality of life (HRQoL) across metabolic, mechanical and mental domains. Gastric bypass surgery improves HRQoL in the short term, but long‐term trajectories remain insufficiently understood. This study evaluated HRQoL 8 years after gastric bypass in a cohort with T2D, integrating quantitative assessments with qualitative exploration of lived experiences.
Methods
Eleven individuals with obesity and T2D who underwent gastric bypass participated in an 8‐year follow‐up. Anthropometric and clinical data were collected. HRQoL was assessed using the RAND SF‐36, and changes over time were analyzed using repeated‐measures ANOVA. Correlations between changes in BMI, HbA1c and HRQoL domains were assessed with Spearman correlations. Semi‐structured qualitative interviews were conducted, transcribed verbatim and analyzed using reflexive thematic analysis.
Results
Participants experienced modest weight regain but significant deterioration in glucose control from the 2‐year to the 8‐year follow‐up. RAND SF‐36 scores returned to preoperative levels, and the mental health score was significantly reduced compared to the 2‐year follow‐up ( q < 0.01). Weight regain correlated with reduced physical functioning, role‐physical and vitality scores (all r < −0.7, p < 0.05), while HbA1c increase correlated with poorer mental health and role‐emotional scores (all r < −0.6, p < 0.05). Qualitative interviews revealed that long‐term HRQoL was dynamic and shaped by an interplay of physical functioning, psychological wellbeing, body adaptations, social support and life events. An overarching theme emerged: Quality of life after gastric bypass is a multidimensional, evolving process influenced by changing health, life circumstances and psychosocial factors over time .
Conclusions
Initial postoperative improvements in HRQoL were not sustained at 8 years and might have been influenced by weight regain, T2D relapse and intercurrent illness. However, lived experiences highlighted meaningful and durable benefits in physical functioning and self‐perception for several participants. The findings underscore the need for long‐term, holistic follow‐up that integrates metabolic monitoring with psychological and social support.
Trial Registration
ClinicalTrials.gov registration: NCT02729246