Impacto de novas comorbidades na qualidade de vida de obesos submetidos à cirurgia bariátrica

Abstract

Obesity is currently a public health problem due to its high prevalence in the population. It is a chronic disease of multifactorial etiology that affects many body systems, causing high morbidity and mortality to their patients. At the moment, the clinical behavioral treatment has shown low efficiency in permanent weight reduction; whereas bariatric surgery has been shown as the most effective option for the treatment of severe obesity and its comorbidities. There is indication for surgical treatment of obesity when people aged 16 years old or more have Body Mass Index (BMI) equal to or greater than 40 kg/m² or BMI equal to or greater than 35 kg/m² associated to serious comorbidities, such as diabetes, hypertension, sleep apnea and osteoarticular degenerative diseases, among others. The bariatric surgery or gastroplasty leads to a significant weight loss which determines an improvement or the resolution of comorbidities. However, other aspects must be considered, as the appearing of postoperative complications by determining the need for new clinical or surgical treatments, which can compromise the quality of life. Aiming to contribute to the discussion of the problem, this dissertation features a review chapter about obesity on its different aspects and an original article referring to a longitudinal, prospective, analytical study of obese adult patients treated at a referral service, and who were in the late postoperative period after the gastroplasty. In the research article, there was evaluated demographic, epidemiological and anthropometric data (pre and postoperative periods) and the quality of life of the patients, through the Impact of Weight on Quality of Life-Lite (IWQOL-Lite) questionnaire. Furthermore, it was investigated the occurrence and carried out a rank of late complications of postoperative period, using the ranking table of BAROS Protocol. It has been observed a significant reduction of the anthropometric measurements (weight, BMI, waist circumference) about the frequency of comorbidities and an improvement in the perception of quality of life after gastroplasty. In spite of that, a substantial frequency of clinical and surgical complications with a negative impact on the command of physical function have been identified, which suggest that the ongoing follow-up of those individuals is mandatory for the early diagnosis and treatment of complications related to the gastroplasty that can introduce new morbidities.