Loneliness and Social Isolation Up to 5 Years after Bariatric Surgery in the Bariatric Experience Long Term (BELONG) Study.

backgroundThere is a large body of research about physical complications following metabolic and bariatric surgery (MBS); less is known about psychosocial sequelae that may adversely affect people’s lives after MBS such as loneliness and social isolation. This is important because loneliness and social isolation may affect health outcomes following MBS.

methodsPatients preparing to have MBS in a large health system were surveyed before (baseline) and at years 1, 3, and 5 following MBS. A total of 1,338 had MBS and were included in follow-up surveys. Survey response rates were 75% (n = 998) for year 1, 71% (n = 949) for year 3, and 50% (n = 672) for year 5.

resultsThe cohort was 38% Hispanic, 86% female, and 43.4 ± 11.3 years old. Adjusted loneliness (scale range 20–80) increased from 32.4 before MBS to 34.6 in year 5 following MBS (p = .01). After 5 years of follow-up, the cumulative incidence of two measures of social isolation, difficulty maintaining friendships and joining community activities, were 18% (95% CI: 15,21) and 20% (95% CI: 17,23) respectively. Increases were most pronounced in men and younger people; and those with a mental illness, lower incomes, and BMI ≥ 50 kg/m2.

conclusionThere were increases in loneliness and social isolation after MBS; however, these changes were small and affected a minority of the patients in the sample. Provision of post-operative social support, for those patients who might benefit most, in the context of comprehensive care such as that provided at an ASMBS Bariatric Surgery Center of Excellence (BSCOE), could help mitigate increases in loneliness and social isolation.