Assessment of quality of life before and after surgery for severe obesity.

Quality of life is poor in obese people because of poor physical health and mental well-being and impaired psychosocial functioning. Obese people perceive discrimination and prejudice against them as their heaviest burden. Reports of absence of psychopathology in obese people reflect adaptation to chronic disease or failure of assessment instruments to detect disturbances. We present information on the extraordinary suffering and perceived discrimination of obese people and discuss econometric assessment of quality of life. The Swedish national population study of obese subjects (SOS) is presented as well as studies of effects of surgical weight loss on quality of life. Most studies lack adequate controls and extrapolations from surgical populations are uncertain. Psychosocial factors are important predictors of outcome in terms of physical as well as mental health. Operated patients with significant weight loss after surgery demonstrate dramatic improvement in quality of life. This alone justifies treating severely obese patients surgically.