Food tolerance, nutritional status and health-related quality of life of patients with morbid obesity after bariatric surgery in a public hospital in Malaysia
Bariatric surgery has been proven to be the most effective weight loss treatment for patients with morbid obesity. However, the alteration in the anatomy of the gastrointestinal structure, food aversion, and non-compliance to recommended dietary advice after bariatric surgery may cause food intol...
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| Main Author: | |
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| Format: | Thesis |
| Language: | English |
| Published: |
2021
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| Subjects: | |
| Online Access: | http://psasir.upm.edu.my/id/eprint/103914/1/ELINA%20TSEN%20POH%20YUE%20-%20IR.pdf |
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| Summary: | Bariatric surgery has been proven to be the most effective weight loss treatment
for patients with morbid obesity. However, the alteration in the anatomy of the
gastrointestinal structure, food aversion, and non-compliance to recommended
dietary advice after bariatric surgery may cause food intolerance, which may
affect the nutritional status and health-related quality of life (HRQOL). This study
aims to determine the effects of bariatric surgery on food tolerance, nutritional
status, and HRQOL among patients with morbid obesity in Malaysia.
This prospective observational study screened a total of 97 patients with morbid
obesity. Data on socio-demographic characteristics, food tolerance, nutritional
status and HRQOL were collected and assessed at baseline, one month and
three months after bariatric surgery. Food tolerance was evaluated using a
validated quality of alimentation questionnaire. The anthropometry
measurements, including the body mass index (BMI) and percent excess weight
loss (EWL), were evaluated, and the dietary intake was collected using a threeday
24-hour food record. The HRQOL was assessed using the World Health
Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire. Data was
collected in the Surgical Outpatient Department (SOPD) clinic, Hospital Kuala
Lumpur, Malaysia.
The final recruited patients with morbid obesity were 90 patients, with a response
rate of 100%. There were 62 females (68.9%) and 28 male (31.1%) patients,
with 50% of the patients’ age less than 40. The EWL one month and three
months after surgery was 14.1% and 31.6%, respectively. There was a
significant decrease in the total food tolerance score from 26.4 (SD = 0.8) at
baseline to 17.7 (SD = 4.7) one month after bariatric surgery, but a gradual rise
in the score to 21.7 (SD = 4.3) was observed three months after surgery. A
similar pattern is seen in the dietary intake assessment where a significant
reduction in the total energy from 1842 kcal (SD = 445) at baseline to 570 kcal
(SD = 180) one month and an increase to 731 kcal (SD = 185) three months after
bariatric surgery. The HRQOL of the study patients showed a statistically
significantly increase in the domain of physical health (t = -7.253, p = < 0.001),
psychological (t = -7.692, p < 0.001), social relationship (t = -5.767, p < 0.001)
and environment (t = -4.208, p < 0.013) three months after bariatric surgery.
In conclusion, the present study showed that bariatric surgery has effectively
reduced weight and improved overall HRQOL domains among patients with
morbid obesity despite reduced food tolerance and energy intake after bariatric
surgery. Future longitudinal studies or randomized controlled trial are
recommended to determine the cause-and-effect mechanisms with larger
sample size about food tolerance, weight loss, dietary intake, HRQOL, and
bariatric surgery in Malaysia. |
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