Graduate Program of Human Nutrition, University of Brasília, Brasília 70910-900, Brazil.
Ministry of Health, Rio de Janeiro 70068-900, Brazil.
Int J Environ Res Public Health. 2023 Aug 1;20(15):6494. doi: 10.3390/ijerph20156494.
Lifestyle and health-related quality of life (HRQoL) are good markers of surgical obesity treatment. This study aimed to investigate the lifestyle and HRQoL of patients at least five years after Roux-en-Y gastric bypass in public (SUS) and private (PVT) Brazilian healthcare systems. In this cross-sectional study, weight loss (WL), % of excess WL (%EWL), diet quality, physical activity, alcohol consumption, and HRQoL were evaluated. Analysis of covariance, binary and multinomial logistic regression, adjusted for confounders, were performed. The SUS group had more vulnerable socioeconomic statuses than the PVT group. Total %WL and % EWL were 24.64 ± 0.99% and 60.46 ± 2.41%, respectively, without difference between groups. In the Pain/Discomfort and Anxiety/Depression domains of HRQoL, more than 50% reported moderate problems without differences between groups. Processed food ingestion was higher in the PVT (132.10 ± 60.15 g/1000 kcal) than in the SUS (103.43 ± 41.72 g/1000 kcal), however, without statistical significance ( = 0.093). The PVT group showed lower physical activity (OR: 0.23; 95%CI: 0.87-0.63; = 0.004) and a higher risk of alcohol-related problems (OR: 3.23; 95%CI; 1.03-10.10; = 0.044) compared to SUS group. Participants generally achieved satisfactory WL, regardless of healthcare systems. However, PVT participants had unfavorable lifestyle characteristics, highlighting the need for studies investigating environmental issues post-bariatric surgery.
生活方式和与健康相关的生活质量（HRQoL）是肥胖手术治疗的良好指标。本研究旨在调查接受 Roux-en-Y 胃旁路手术后至少 5 年的患者在巴西公共（SUS）和私人（PVT）医疗保健系统中的生活方式和 HRQoL。在这项横断面研究中，评估了体重减轻（WL）、 excess WL（%EWL）、饮食质量、身体活动、饮酒和 HRQoL。进行了协方差分析、二元和多项逻辑回归分析，并进行了混杂因素调整。SUS 组的社会经济地位比 PVT 组更脆弱。总 %WL 和 %EWL 分别为 24.64 ± 0.99%和 60.46 ± 2.41%，两组之间无差异。在 HRQoL 的疼痛/不适和焦虑/抑郁领域，超过 50%的患者报告存在中度问题，但两组之间无差异。加工食品的摄入量在 PVT（132.10 ± 60.15 g/1000 kcal）中高于 SUS（103.43 ± 41.72 g/1000 kcal），但无统计学意义（ = 0.093）。与 SUS 组相比，PVT 组的身体活动较少（OR：0.23；95%CI：0.87-0.63； = 0.004），且有更高的酒精相关问题风险（OR：3.23；95%CI；1.03-10.10； = 0.044）。无论医疗保健系统如何，参与者通常都实现了令人满意的 WL。然而，PVT 参与者的生活方式特征不利，突出了需要研究肥胖手术后的环境问题。
