PainRelief.com: What are the main findings?
Response: Among 1491 US adults, with a median age of 47 years and median body mass index of 47 kg/m2, we found declines in pre-to-postoperative improvements across follow-up were relatively small. As a result, clinically important improvements in bodily and join-specific pain and physical function were common 7 years after undergoing RYGB or SG.
For example, approximately two-thirds of participants continued to experienced clinically important improvements in a summary measure of physical function, as well as symptoms of osteoarthritis of the knee and hip, and half of participants continued to experienced clinically important improvements in walk time. Close to half (43%) had sustained improvements in bodily pain. Additionally, work presenteeism (i.e., impaired work due to health) decreased. These results are particularly impressive considering the cohort aged 7 years across follow-up, such that many of them were in age groups in which declines in these measures are common.
PainRelief.com: What should readers take away from your report?
Response: This study suggests RYGB and SG commonly lead to durable improvements in pain, physical function and work presenteeism. In general, the benefits of these procedures far outweigh the risks. However, patients should only make the decision to undergo a bariatric procedure after being evaluated by a reputable program and going through their patient education program. Such programs are designed to help patients make informed decisions and make behavioral changes that will promote optimal outcomes.
PainRelief.com: What recommendations do you have for future research as a result of this study?
Response: While this study provides strong evidence for the beneficial effects of RYGB and SG on pain and physical function, it also demonstrates that not all patients maintain clinically important improvements over long-term follow-up. Some postoperative patients likely experience levels of pain and disability that affect their quality of life and interfere with adopting or maintaining an active lifestyle, especially as time from surgery increases. Thus, there is a need to test and identify effective interventions for postoperative patients who require additional interventions to improve pain and physical function outcomes.
PainRelief.com: Is there anything else you would like to add?
Response: This study included many different measures of pain and function. Measures that captured the most severe impairment (e.g., a mobility deficit, defined as inability to walk 400 meters in 7 minutes) showed the least improvement, suggesting that undergoing RYGB or SG sooner, before physical disability is severe, may yield greater benefits.
King WC, Hinerman AS, White GE. A 7-Year Study of the Durability of Improvements in Pain, Physical Function, and Work Productivity After Roux-en-Y Gastric Bypass and Sleeve Gastrectomy. JAMA Netw Open. 2022;5(9):e2231593. doi:10.1001/jamanetworkopen.2022.31593
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