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A call to arms: obese men with more severe comorbid disease and underutilization of bariatric operations

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Abstract

Background

Despite similar rates of obesity among American men and women, population-based studies suggest that bariatric surgery patients are disproportionately female. We sought to assess this observation quantitatively.

Methods

Data were prospectively collected from 1,368 consecutive patients evaluated for bariatric surgery over a 4-year period. The prevalence of diabetes mellitus (DM), hypertension (HTN), dyslipidemia (DYS), obstructive sleep apnea (OSA), gastroesophageal reflux disease, depression, back pain (BKP), and musculoskeletal peripheral disease was assessed. A severity score from 1 to 5 had been assigned to each comorbidity based on the Assessment of Obesity Related Comorbidities Scale (AORC). Metabolic syndrome (MetS) was defined as the concurrent presence of DM, HTN, and DYS.

Results

The majority of patients were female (n = 1,115, 81.5 %). Male patients were older (44.5 ± 9.5 vs. 42.6 ± 9.6 years, p = 0.0044) and had higher body mass index (48.7 ± 7.8 vs. 46.6 ± 7.4 kg/m2, p < 0.0001). On average, men presented with 4.54 serious comorbidities and 3.7 complicated comorbidities (AORC score ≥3), whereas women presented with 4.15 serious comorbidities and 3.08 complicated comorbidities. More men presented with DM (36.4 vs. 28.9 %, p = 0.0154), HTN (68.8 vs. 55.3 %, p = 0.0001), OSA (71.9 vs. 45.7 %, p < 0.0001), and MetS (20.9 vs. 15.2 %, p = 0.0301). Men also presented with more complicated DM (33.2 vs. 23.9 %, p = 0.0031), DYS (36.8 vs. 23.5 %, p < 0.0001), HTN (58.9 vs. 44.6 %, p < 0.0001), BKP (25.3 vs. 19.3 %, p = 0.0378), OSA (56.9 vs. 30.1 %, p < 0.0001), and MetS (17.8 vs. 10.0 %, p = 0.001).

Conclusions

Although men typically comprise less than 20 % of bariatric surgery patients, they potentially have more to gain from these operations. Men present later in life, with more advanced obesity, and with more complicated comorbidities. Such findings mandate more research and resources to investigate this barrier to treatment and to provide the morbidly obese male with the surgical care he clearly needs.

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Acknowledgments

This publication was supported by a fellowship education grant from the Foundation for Surgical Fellowships.

Disclosures

Gina Farinholt, Aaron Carr, Eun Jin Chang, and Mohamed Ali have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of Surgery, University of California, Davis, 2221 Stockton Boulevard, Sacramento, CA, 95817, USA

    Gina N. Farinholt, Aaron D. Carr, Eun Jin Chang & Mohamed R. Ali

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  1. Gina N. Farinholt
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  2. Aaron D. Carr
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  3. Eun Jin Chang
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  4. Mohamed R. Ali
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Correspondence to Mohamed R. Ali.

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Farinholt, G.N., Carr, A.D., Chang, E.J. et al. A call to arms: obese men with more severe comorbid disease and underutilization of bariatric operations. Surg Endosc 27, 4556–4563 (2013). https://doi.org/10.1007/s00464-013-3122-1

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