Impacto da cirurgia bariátrica na qualidade de vida

Abstract

Obesity is defined as an excessively high amount of body fat, with a positive energy balance and body composition change, related to genetic and enviromental determinants. It has been reaching high prevalence all around the world, turning into a global epidemic and becoming a public health issue. Its etiology is involved in enviromental and exogenous factors and it is considered a multifactorial disease, which may be triggered by several factors such as: neuroendocrine changes, high caloric intake, sedentary lifestyle and emotional weakness, among other things. Its diagnosis and management are commonly performed using anthropometric measurements and the evaluation associated to the body mass and distribution of abdominal fat is considered a suitable option to clinical and risks evaluations. The risks are mainly related to the emergence of comorbidities associated to obesity, such diabetes, hypertension, kidney failure, dyslipidemia, cerebrovascular accident, cancer, among others. The conventional treatment includes pharmacotherapy, dietary guidelines and physical activities. Nonetheless, to severe obese, the conventional treatment is not enough. They occasionally need surgical intervention which normally leads to a significant weight loss and improvement or resolution of comorbidities. However, once the severe obesity causes musculoskeletal, psychic and clinical changes which might damage the quality of life, the post-op weight loss must be taken into account, since even after the surgical procedure, the appearance of new diseases or the deficient cure of others may compromise the quality of life of the patients. Aimed at contributing to the discussion of the issue, this thesis presents not only a review chapter but also an original article with regard to an observational, longitudinal, prospective and analytical study with obese individuals subjected to bariatric surgery. They had been evaluated before and after surgery through aspects of comorbidities and quality of life, using the Impact of Weight on Quality of Life-Lite (IWQOL-Lite) questionnaire. After a year since the surgical procedure, the patients showed a decrease in the comorbidities as hypertension, diabetes , dyslipidemia and hypothyroidism; significant reduction in anthropometric measurements and biochemical dosages and a significant improvement in post-op quality of life (p < 0,001), which shows the benefit of the surgery in clinical and quality of life aspects. Howsoever, the BMI values and waist circumference remained unchanged. This fact shows that it is necessary to keep the study segment for a longer time and perform new research.