Study finds improvements in pain, productivity persist long after bariatric surgery

Despite occasional relapses from the rapid recovery seen in the years after surgery, gains in pain, physical function, and job productivity continue at least seven years.

The study’s findings were published in the journal JAMA Network Open. The findings of the study – which suggest that gains remain even as people age over the course of the study – can aid physicians, health insurance providers, and patients, many of whom have surgery to relieve joint discomfort and enhance mobility.

“Adults with severe obesity are much more likely to experience significant joint pain and limits to their physical abilities,” said Wendy C. King, Ph.D., associate professor of epidemiology in Pitt’s School of Public Health. “Obesity leads to an earlier need for knee and hip replacement. However, adults with severe obesity may be denied joint surgery until they lose weight. And, if physical limitations and pain interfere with job performance, losing weight could be necessary to maintain employment.”

King and her colleagues tracked 1,491 people who had Roux-en-Y gastric bypass or sleeve gastrectomy between 2006 and 2009, the two most popular and successful surgical procedures for extreme obesity. The research participants had a median age of 47 years at the time of surgery, and 80% were female.

The patients were included in the National Institutes of Health-funded Longitudinal Assessment of Bariatric Surgery-2 (LABS-2), a prospective cohort study of weight-loss surgery patients in the United States.

The current study relies on a previous study by King and her colleagues, which found that 50% to 70% of study participants reported clinically significant improvements in pain levels, physical function, and typical walking pace three years after bariatric surgery.

The researchers discovered that after seven years after surgery, 43% of patients showed clinically significant improvements in pain, 64% in physical function, and 50% in 400-meter walk time, all of which were down between 7 and 11 percentage points from the three-year evaluation.

At seven years post-surgery, 65% of individuals with symptoms suggestive of osteoarthrosis reported improvements in hip pain, while 72% reported improvements in knee function, both down from 77% at three years post-surgery.

The minor to moderate decreases in pain and increases in physical function are not surprising, given that the patients matured to a median of 54 years throughout the duration of the trial, according to King.

Previous research shows that some aspects of physical function, such as balance and strength, start to decline when people enter their 50s, and others, such as walking speed and aerobic endurance, typically decline in the sixth decade of life.

“On average, participants experienced durable improvements in walking speed, fitness and almost all metrics of pain,” King said.

In addition, participants reported that pain and health status interfered less with their ability to work post-surgery, with 43% of participants reporting impaired work due to health seven years post-surgery, down from 63% pre-surgery.

“Combined, our study provides great news about the lasting effects of bariatric surgery,” King said. “But clinicians should look at patients as individuals and consider their complete health history, goals and motivations for weight loss when providing presurgical counseling on potential results.”