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Change in Pain and Physical Function Following Bariatric Surgery for Severe Obesity

Importance  The variability and durability of improvements in pain and physical function following Roux-en-Y gastric bypass (RYGB) or laparoscopic adjustable gastric banding (LAGB) are not well described.

Objectives  To report changes in pain and physical function in the first 3 years following bariatric surgery, and to identify factors associated with improvement.

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Introduction

Severe obesity is associated with significant joint pain and impaired physical function (ability to bend, lift, carry, push, and walk).1,2 Excess weight bearing can lead to joint damage and pain, resulting in activity restriction and walking limitations.3 Obesity can also contribute to pain and physical limitations through factors such as impaired cardiorespiratory function,4 systematic inflammation,5reduced flexibility of movement,6 low strength per body mass,5 and depression.7

Bariatric surgery is effective at achieving and maintaining weight loss, and inducing remission or reducing severity of many comorbidities such as type 2 diabetes mellitus, hypertension, dyslipidemia, and depression.8,9 Although evidence of improvements in pain and physical function following bariatric surgery is increasing, the variability and durability of improvement have not been well described—with most studies limited by small sample size and follow-up of 1 year or less or by the study of obsolete surgical procedures.10– 12

This report examines pain and physical function outcomes in a large multisite cohort study with annual follow-up. The aim of the study was to evaluate changes in bodily and joint-specific pain and physical function, including perceived and objectively measured walking capacity in the first 3 years following bariatric surgery, and to identify factors associated with presurgery-to-postsurgery improvements.

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