Cohort-Based Reference Percentiles for six BODY-Q Health-Related Quality of Life Scales after Metabolic and Bariatric Surgery

Patient-reported outcome measures (PROMs) are essential in follow-up after metabolic and bariatric surgery (MBS), capturing health-related quality of life (HRQL). The BODY-Q includes HRQL scales relevant to patients undergoing MBS but cohort-based reference percentiles for postoperative interpretation are limited.

To derive five-year cohort-based reference percentiles for six BODY-Q HRQL scales after MBS.

Patients aged 18-65 with laparoscopic Roux-en-Y gastric bypass (LRYGB) or sleeve gastrectomy (LSG) at two Dutch centers (2017-2019) were included. HRQL was assessed preoperatively, at 4 months and annually to 5 years using six BODY-Q scales: body image, physical functioning, physical symptoms, and psychological, social and sexual well-being. BODY-Q scores were converted to a 0-100 scale and summarized at the 10th, 25th, 50th, 75th and 90th percentiles. Subgroups were surgery type, sex, age and BMI.

391 patients were analyzed (85.9% female; mean BMI 42.8 ± 4.5 kg/m²). At 5 years, 144-146 patients had available scores for non-optional HRQL scales and 91 for Sexual well-being. Scores improved from baseline to 5 years, but later estimates should be interpreted in light of attrition. Trajectories were broadly comparable for LRYGB and LSG. Stratified analyses suggested variation by procedure type, sex, age and baseline BMI, but subgroup findings should be interpreted cautiously because some later follow-up cells were small.

This study provides exploratory five-year cohort-based reference percentiles for six BODY-Q HRQL scales after MBS. These percentiles provide descriptive context for interpreting postoperative scores, but should not be considered definitive normative standards, clinical benchmarks or decision thresholds without external validation.