Physical function improvements after laparoscopic Roux-en-Y gastric bypass surgery

Abstract

Background: Obesity is a risk factor for impaired physical function and disability, with the degree of impairment most compromised in extreme obesity. Mild-to-moderate weight loss has been shown to improve function in older adults. The impact of laparoscopic Roux-en-Y gastric bypass surgery on weight loss and physical function in morbidly obese individuals was assessed.

Methods: This longitudinal, observational study followed up 28 morbidly obese men and women (body mass index > or = 40.0 kg/m(2)) for 12 months after laparoscopic Roux-en-Y gastric bypass. Physical function (self-report using the Fitness Arthritis and Seniors Trial disability questionnaire; performance tasks using the Short Physical Performance Battery and a lateral mobility task); strength (maximal isometric knee torque); and body composition measured using bioelectrical impedance were determined before surgery (baseline) and at 3 weeks, 3 months, 6 months, and 12 months after surgery.

Results: The 12-month weight loss was 34.2% (excess weight loss 59.8%), with a mean fat mass loss of 46 kg and a loss of fat free mass of 6.6 kg. The performance tasks and self-reported questionnaire scores had improved by 3 months after surgery compared with baseline, with selected measures showing less impairment and disability in as few as 3 weeks after surgery. Muscle quality, as measured using the maximal torque per kilogram body weight, was greater at 6 months than at baseline.

Conclusion: The results of our study have shown that in morbidly obese individuals with a high risk of mobility impairments, surgical procedures to reduce body weight increase mobility and improve performance of daily activities in as few as 3 weeks after gastric bypass surgery.

Fig. 1.

Body weight during 12-month follow-up. Data presented as estimated marginal means with standard error of mean (n = 19).

Fig. 2.

Relative weight loss as percentage of (A) total weight and (B) excess weight. Data presented as estimated marginal means with standard error of mean (n = 19).

Fig. 3.

Percentage of changes from baseline in SPPB and FAST physical function measures across 12-month follow-up period. Data presented as estimated marginal means with standard error of mean (n = 19).

Fig. 4.

Percentage of changes from baseline in gait speed, chair rise time, lateral mobility time, and maximal torque across 12-month follow-up period. Data presented as estimated marginal means with standard error of mean (n = 19).