Bariatric surgery aims to help severely obese patients shed significant weight, and now new research shows that many can also look forward to lasting pain relief and mobility.
Though many patients regain some weight in the first couple of years after bariatric surgery, pain and movement benefits seem to stand the test of time. Seven years out, 43% of the roughly 1,500 patients enrolled in the study said their joint pain remained noticeably lower than before surgery, and nearly two-thirds said their physical functioning was still better.
"Previous studies had provided evidence that bariatric surgical procedures are associated with clinically important improvements in pain, physical function and work productivity; however, most studies only followed participants one to two years, at which point participants were at the peak of their weight loss," said lead author Wendy King. She's an associate professor at the University of Pittsburgh School of Public Health.
King and her colleagues found that patients were experiencing "clinically important improvements in bodily and joint-specific pain and physical function" seven years after the two most common types of bariatric surgery -- Roux-en-Y gastric bypass or sleeve gastrectomy.
The new study builds on prior research by the same team, which found that three years after bariatric surgery, 50% to 70% of patients reported less pain, as well as better walking speeds and broadly improved physical function.
Patients in the new study had weight-loss surgery between 2006 and 2009. About 8 in 10 were white women, ranging in age from 38 to 55.
Between three and seven years after surgery, the percentage of patients who were still reporting clinically important gains in pain, physical function and walking speed dropped -- all down between 7 and 11 percentage points, the study found.
Even so, seven years out, half were still striding faster when completing a 400-meter walk than before surgery. Forty-three percent were still seeing significant improvements in pain and 64% in physical function.
A better ability to handle the physical demands of work was another enduring benefit of the surgery.
While nearly two-thirds of participants said that joint pain and their overall state of health had interfered with their ability to do their jobs before surgery, that dropped to 43% seven years later.
"I was impressed by the durability of initial pre- to post-surgery improvements in pain, function and work productivity," said King, who added that the declines between three and seven years were small, especially considering that participants getting older.
Overall, the findings add to the conviction that "the benefits of modern day bariatric surgical procedures -- that is, Roux-en-Y gastric bypass and sleeve gastrectomy -- far outweigh the risks," King said.
Lona Sandon, a program director in the School of Health Professions at University of Texas Southwestern Medical Center in Dallas, reviewed the findings.
She said that the additional benefits highlighted in the study are well known to doctors, who typically point them out to potential patients, even when patients' primary motivation for surgery may be weight loss rather than pain relief.
"Insurance does not approve surgery based on pain scales or movement capacity, as these are not considered medical diagnoses," while obesity is, Sandon said.
"Insurance is also not good at paying for prevention. Therefore, weight gets the primary focus," she said, leaving patients to regard any additional benefits of surgery as a "bonus" if and when they experience them.
"It is nice to see a long-term study showing these benefits last over time," Sandon said. "Physically feeling better with less pain and greater ability to move can do a lot to improve mood and quality of life."
The findings were published Sept. 14 in JAMA Network Open.
The American Society for Metabolic and Bariatric Surgery has more about the benefits of weight-loss surgery.
SOURCES: Wendy King, PhD, associate professor, epidemiology, University of Pittsburgh School of Public Health; Lona Sandon, PhD, RDN, LD, program director and associate professor, clinical nutrition, UT Southwestern Medical Center, Dallas; JAMA Network Open, Sept. 14, 2022