Eight-year evolution of quality of life after sleeve gastrectomy: A prospective cohort study.

INTRODUCTION: Laparoscopic sleeve gastrectomy (LSG) yields strong short- and mid-term outcomes, but long-term quality-of-life (QoL) trends remain less defined. Our objectives were to assess 8-year changes in weight, obesity-related medical problems (ORMPs) and QoL after LSG. PATIENTS AND METHODS: This prospective cohort included 106 adults who underwent LSG (2016-2017). Assessments were performed preoperatively and at 1, 5 and 8 years using anthropometric data, ORMPs' status and the Moorehead-Ardelt II QoL questionnaire. Fifty-four patients completed 8-year follow-up. Linear mixed-effects and non-parametric tests were used for paired comparisons. RESULTS: The mean percentage of excess weight loss declined from 73.2% at 1 year to 63.4% at 8 years, with excellent weight loss outcomes decreasing from 92.6% to 81.5% and failure rates rising to 16.7%. QoL improved from - 0.44 preoperatively to 1.80 at 1 year, peaked at 1.99 at 5 years and then declined to 1.41 at 8 years. Weight loss independently predicted higher QoL (β = +0.019 per kg lost, P < 0.001). Most ORMPs remained improved long term, while gastroesophageal reflux disease and smoking increased. CONCLUSIONS: LSG provides durable long-term benefits; however, attenuation after 5 years and rising behavioural and reflux-related risks highlight the importance of structured, multidisciplinary, lifelong follow-up to preserve outcomes and QoL.