Medical therapy

Physical health, improved quality of life with bariatric surgery compared to medical therapy

April 26, 2021

1 minute read



Aminan A, et al. Patient-reported outcomes after metabolic surgery versus medical treatment for diabetes: insights from the STAMPEDE randomized trial. Presented at the American Surgical Association Annual Meeting; April 15-16, 2021 (virtual meeting).

Disclosures: The authors report no relevant financial information.

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According to new data from the STAMPEDE trial, adults with type 2 diabetes who underwent bariatric surgery reported more energy, less fatigue and better overall health compared to those assigned medical treatment.

Ali Aminian

“Patient-reported outcomes are determined directly by patients without interpretation by clinicians,” Ali Aminian, doctor, associate professor of surgery and director of the Cleveland Clinic’s Bariatric and Metabolic Institute, Healio told Healio. “Compared to the general population, patients with chronic conditions such as severe obesity and diabetes have lower quality of life scores and their scores gradually decline over time. It is important to study the effects of different modalities of treatment of these chronic diseases on the well-being of patients in their daily lives.

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Aminian and colleagues analyzed data from 104 adults with type 2 diabetes who underwent Roux-en-Y gastric bypass surgery, sleeve gastrectomy, or intensive medical treatment as part of the STAMPEDE trial, a trial randomized controlled trial assessing the long-term effects of treatments for type 2 diabetes. Participants completed two general quality-of-life questionnaires (SF-36 and EQ-5D-3L) and a diabetes-specific instrument at baseline, then on on an annual basis up to 5 years after randomization.

Researchers found that participants who underwent Roux-en-Y or sleeve gastrectomy reported improved overall perception of health, energy/fatigue, and diabetes-related quality of life compared to those who assigned to intensive medical therapy alone.

“None of the quality of life components improved significantly from baseline in the intensive medical treatment group,” the researchers wrote in an abstract.

The researchers observed no differences between study groups in measures of psychological and social aspects of quality of life. In multivariate analysis, the independent factors associated with better perceived long-term general health status were initial general health status (P .001), not taking insulin at age 5 (P= .005), Roux-en-Y gastric bypass vs intensive medical treatment (P= .005) and sleeve gastrectomy vs intensive medical treatment (P= .034). Changes were similar in analyzes stratified by type of surgery.

“While it is encouraging that the weight loss and improved cardiometabolic profile of patients after metabolic surgery resulted in profound improvements in self-reported physical health, long-term changes in the psychological, emotional and social aspects of quality of life weren’t that noticeable,” Aminian told Healio. “Our results suggest that psychological well-being needs require more attention in metabolic surgery patients.”