SOURCE: King WC, Chen JY, Belle SH, et al. Change in pain and physical function following bariatric surgery for severe obesity. JAMA 2016;315:1362-1371.
The metabolic benefits of bariatric surgery are prompt, significant, and — for the most part — durable. Many patients who suffer from severe obesity also experience joint pain (especially knee and hip) and limited mobility. What kind of effect does bariatric surgery have on those endpoints?
King et al reported on outcomes among patients with severe obesity (median body mass index = 49.5 kg/m2) who underwent bariatric surgery (n = 2,221). The outcomes of interest were bodily pain and physical function, as measured by SF-36. To be considered “improved,” patients had to meet the threshold for minimal meaningful increment of change, rather than just achieve statistical significance alone.
At one year, the majority of surgical subjects demonstrated clinically meaningful improvements in pain and physical function. Specifically addressing those already experiencing disability due to knee (n = 633) or hip (n = 500) pain at baseline, more than 75% of each group reported symptomatic improvement at one year, which was durable through three years of observation.
In addition to the favorable metabolic changes (e.g., remission of diabetes, prevention of diabetes) associated with bariatric surgery, meaningful improvements in physical function and disability due to joint pain occur promptly and are durable through at least three years of follow-up.