New research shows bariatric surgery may contribute to long-lasting improvement in pain and physical abilities.
Weight loss surgery has many proven benefits, including reducing blood pressure, improving blood sugars, and reducing cardiovascular risk. Now, data from a large multicenter study of bariatric surgery in the US suggest long-lasting improvement of pain and physical function can be added to this list.
What did the study look at?
This study followed after they had either Roux-en-Y gastric bypass or sleeve gastrectomy, the two most common bariatric surgery procedures. Most of the participants were female (80%) and white (82%), with Hispanic (4%) and Black participants (11%) less well represented. Their ages ranged from 38 to 55, and all had been diagnosed with severe obesity (a body mass index of 35 or greater).
Before their surgery, participants completed questionnaires reporting their physical abilities, pain, health, and quality of life. Many also were tested for measures of physical function and mobility, such as being able to walk 400 meters in seven minutes or less. Some reported severe or even disabling knee or hip pain, a symptom of osteoarthritis. Assessments were repeated annually for up to seven years.
What were the findings?
When the study concluded, 41% to 64% of participants reported improvements in body pain and physical function and objectively measured walking ability. Additionally, 65% to 72% of those with osteoarthritis symptoms felt less knee and hip pain. And 41% of those unable to walk 400 meters in less than seven minutes before surgery could now do so.
Not all measures were better; for example, the medication used for back pain before weight loss surgery and at the end of the study remained the same. It’s also worth noting that not everyone experienced improvements in pain and physical function. And the lack of a control group that did not have weight loss surgery makes it hard to be sure whether the positive changes were due to surgery and whether one type of surgery was better.
Why are these results impressive?
We know that the improvements in health and physical function after bariatric surgery is most significant in the first one to two years after surgery. Between three to seven years after surgery, the positive effects on weight, cardiovascular and diabetes health metrics, and health-related quality of life generally decline, even though the net effect remains positive overall.
Most studies of joint pain, physical function, and work productivity after weight loss surgery are limited to two years of follow-up. As a result, it is still being determined how long people can sustain their improvements after surgery. This study shows evidence of long-term positive changes in important clinical outcomes that matter in daily life: how much body or joint pain people experience, what tasks they can perform for themselves, how mobile they are, and how they feel about their quality of life.
Why does obesity worsen joint pain?
Obesity contributes to (note: automatic download), which can lead to osteoarthritis, a progressive disease caused by joint wear and tear. The hips and knees are most commonly affected. Each pound of body weight puts four to six pounds of pressure on each knee joint, and people with obesity are 20 times more likely to need a knee replacement than those who are not overweight.
The bottom line
Obesity has harmful effects on the joints. Bariatric surgery, an effective treatment for significantly reducing body weight, can improve pain, physical abilities, and symptoms.
