Oral Papers: Medical Specialties III: Emergency Medicine, Surgery
Background: Bariatric surgery, an effective treatment resulting in durable weight loss for patients with severe obesity, can improve mental and physical health-related quality of life (HRQOL), and consequently, work capacity. Our study purpose was to evaluate changes to employment impairment (EI) and related HRQOL in patients 2-years post-bariatric surgery. We hypothesized that employment capacity and mental and physical HRQOL would all improve 2 years following bariatric surgery. As a secondary objective, we also aimed to identify potential psychosocial predictors of employment outcomes following bariatric surgery.
Methods: Prospective data was collected on a cohort of 211 patients who underwent bariatric surgery. The Lam Employment Absence and Productivity Scale (LEAPS) and the 36-Item Short Form Survey were used to assess pre- and post-operative EI and physical and mental HRQOL, respectively. Predictors of work impairment changes were analyzed via multiple regression analysis and included demographic variables, history of psychiatric illness and depression and anxiety measures.
Results: The majority of the participants were female (81.9%), full-time workers prior to surgery, employed in sales or service industries (24.3%), and had a mean pre-surgery BMI of 48.9 kg/m2 and mean age pre-surgery of 44.86 years. Significant improvements in employment outcomes 2-years following surgery were noted with 68% of participants reporting an overall decrease in EI (total LEAPS score change=-2.43±5.76, p< 0.001), and 44% participants reporting an increase in work productivity (LEAPS productivity score change=-0.67±2.38, p< 0.001). Bariatric surgery was also associated with significant improvements in physical (change=17.41±10.72, p< 0.001), and mental (change=2.67±12.89, p=0.001). Improvements in HRQOL predicted improvements in work-related impairment and productivity, while history of psychiatric illness predicted was associated with reduced improvement in work productivity.
Discussion: As predicted, improvements in employment-related functioning and HRQOL were maintained 2 years following bariatric surgery. The findings suggest that improvements in mental quality of life continue to predict improved work-related functioning at 2-years post-surgery. A novel finding was that improvements in physical quality of life predicted two-year outcomes both in EI and productivity, while alleviation of anxiety and depression symptoms were unrelated to either outcome of work functioning. In addition, a past history of Axis I disorders was associated with a smaller improvement in work productivity after surgery.
Conclusions: In summary, the study results further support the significant improvements in work capacity and mental and physical wellbeing experienced by patients after bariatric surgery. Interventions aimed at supporting and maintaining post-operative mental health outcomes after bariatric surgery may further enhance employment-related functioning and warrant further study.
Mancini A et al. Bariatric surgery improves the employment rate in people with obesity: 2-year analysis. Surg Obes Relat Dis 2018;14(11):1700-4.
Sockalingam S et al. Employment outcomes one year after bariatric surgery: the role of patient and psychosocial factors. Obes Surg 2015;25(3):514-22