Health Status and Patients' Satisfaction on the Long Term after Metabolic/Bariatric Surgery

Introduction: Bone fractures and vitamin deficiencies are potential long-term risks after metabolic/bariatric surgery (MBS). This study aimed to evaluate the health status of patients with an average follow-up of 15 years after MBS, focusing on vitamin deficiencies, patients' satisfaction, and bone fractures.

A questionnaire-based cross-sectional study was performed. In total, 844 patients, with a history of MBS before March 2010, were eligible and contacted by mail. Overall, 263 patients returned the questionnaire.

Roux-en-Y gastric bypass (RYGB) was the most common bariatric procedure (69%), followed by adjustable gastric banding (AGB) in 23% and sleeve gastrectomy (SG) in 8%, respectively. A total of 14% reported bone fractures after MBS. However, the prevalence of bone fractures was similar after RYGB and after restrictive procedures (RYGB: 17% vs. AGB+SG: 11%; p > 0.05). Moreover, no association between the occurrence of bone fractures and the follow-up time was found. Patients with mixed (RYGB) procedures had more vitamin deficiencies compared to patients with dominantly restrictive (AGB+SG) procedures (RYGB: 76% vs. AGB+SG: 54%; p < 0.05). The self-reported health status (RYGB: 64% good-excellent, 36% fair-poor vs. AGB+SG: 53% good-excellent, 46% fair-poor; p > 0.05) was not different between the procedures. However, more patients after RYGB answered that "they would undergo the procedure again" compared to patients after SG or AGB (RYGB: 84% vs. AGB+SG: 61%; p < 0.001).

Even though a higher prevalence of vitamin deficiencies following RYGB was found, the number of patients who were satisfied with the decision made at the time of the initial operation was higher among patients with RYGB compared to SG and AGB.