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Bariatric Surgery and Risk of Unemployment and Sickness Absence

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Abstract

Background

Obesity is associated with adverse labor market outcomes. We examine whether undergoing bariatric surgery is associated with better labor market outcomes such as lower risks of unemployment and sickness absence.

Methods

This is a register-based cohort study of 9126 patients undergoing bariatric surgery from 2005 to 2013 and a reference group of 10,328 individuals with obesity. Age: 18–60 years, body mass index (BMI): 32–60 kg/m2. Participants were either working, unemployed, or on sickness absence at baseline. Inverse probability of treatment weighting was used to account for baseline differences between the two groups. Relative risk ratios of labor market participation were estimated at 1 year, 3 years, and 5 years of follow-up.

Results

Women who had undergone bariatric surgery had a higher risk of unemployment 1 year (RRR = 1.20 (95% CI: 1.02–1.41)) and 5 years (RRR = 1.23 (95% CI: 1.05–1.44)) after surgery; however, men with bariatric surgery had a lower risk of unemployment after 5 years (RRR = 0.71 (95% CI: 0.55–0.92)). The risk of sickness absence was higher at all follow-up time points for both men and women who had undergone bariatric surgery compared with non-operated references with obesity.

Conclusions

Men undergoing bariatric surgery had a lower risk of unemployment 5 years after surgery compared with non-operated men with obesity; however, women presented a higher risk of unemployment after 5 years. The risk of sickness absence was higher for both men and women up to 5 years after undergoing bariatric surgery.

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References

  1. Afshin A, Forouzanfar MH, Reitsma MB, et al. Health effects of overweight and obesity in 195 countries over 25 years. N Engl J Med. 2017;377(1):13–27.

    Article  PubMed  Google Scholar 

  2. Kolotkin R, Meter K, Williams GJOr. Quality of life and obesity. Obesity reviews. 2001;2(4):219–29.

    Article  CAS  PubMed  Google Scholar 

  3. Puhl RM, Heuer CA. The stigma of obesity: a review and update. Obesity (Silver Spring). 2009;17(5):941–64.

    Article  Google Scholar 

  4. Bramming M, Jørgensen MB, Christensen AI, et al. BMI and labor market participation: a cohort study of transitions between work, unemployment, and sickness absence. Obesity. 2019;27(10):1703–10.

    Article  PubMed  Google Scholar 

  5. Stronks K, Mheen H, Van De Bos J, et al. The interrelationship between income, health and employment status. Int J Epidemiol. 1997;26(3):592–600.

    Article  CAS  PubMed  Google Scholar 

  6. Berchick ER, Gallo WT, Maralani V, et al. Inequality and the association between involuntary job loss and depressive symptoms. Social science medicine. 2012;75(10):1891–4.

    Article  PubMed  Google Scholar 

  7. Gallo WT, Bradley EH, Falba TA, et al. Involuntary job loss as a risk factor for subsequent myocardial infarction and stroke: findings from the Health and Retirement Survey. Am J Ind Med. 2004;45(5):408–16.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Martikainen PT, Valkonen T. Excess mortality of unemployed men and women during a period of rapidly increasing unemployment. The Lancet. 1996;348(9032):909–12.

    Article  CAS  Google Scholar 

  9. Waters LE. Coping with unemployment: a literature review and presentation of a new model. Int J Manag Rev. 2000;2(2):169–82.

    Article  Google Scholar 

  10. Puzziferri N, Roshek TB 3rd, Mayo HG, et al. Long-term follow-up after bariatric surgery: a systematic review. JAMA. 2014;312(9):934–42.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Sjöström L, Lindroos A-K, Peltonen M, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351(26):2683–93.

    Article  PubMed  Google Scholar 

  12. Karlsson J, Taft C, Ryden A, et al. Ten-year trends in health-related quality of life after surgical and conventional treatment for severe obesity: the SOS intervention study. Int J Obes. 2007;31(8):1248–61.

    Article  CAS  Google Scholar 

  13. Burgmer R, Petersen I, Burgmer M, et al. Psychological outcome two years after restrictive bariatric surgery. Obes Surg. 2007;17(6):785–91.

    Article  PubMed  Google Scholar 

  14. Lynge E, Sandegaard JL, Rebolj M. The Danish National Patient Register. Scand J Public Health. 2011;39(7 Suppl):30–3.

    Article  PubMed  Google Scholar 

  15. Eriksen L, Gronbaek M, Helge JW, et al. The Danish Health Examination Survey 2007–2008 (DANHES 2007–2008). Scand J Public Health. 2011;39(2):203–11.

    Article  PubMed  Google Scholar 

  16. Christensen AI, Ekholm O, Glumer C, et al. The Danish National Health Survey 2010. Study design and respondent characteristics. Scand J Public Health. 2012;40(4):391–7.

    Article  PubMed  Google Scholar 

  17. Ekholm O, Hesse U, Davidsen M, et al. The study design and characteristics of the Danish national health interview surveys. Scand J Public Health. 2009;37(7):758–65.

    Article  PubMed  Google Scholar 

  18. Arbejdsmarkedsstyrelsen. DREAM version 39. Manual. Copenhagen: Arbejdsmarkedsstyrelsen; 2017.

  19. Pedersen CB. The Danish Civil Registration System. Scand J Public Health. 2011;39(7 Suppl):22–5.

    Article  PubMed  Google Scholar 

  20. Jensen VM, Rasmussen AW. Danish Education Registers. Scand J Public Health. 2011;39(7 Suppl):91–4.

    Article  PubMed  Google Scholar 

  21. Charlson ME, Pompei P, Ales KL, et al. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40(5):373–83.

    Article  CAS  PubMed  Google Scholar 

  22. Thygesen SK, Christiansen CF, Christensen S, et al. The predictive value of ICD-10 diagnostic coding used to assess Charlson comorbidity index conditions in the population-based Danish National Registry of Patients. BMC Med Res Methodol. 2011;11(1):83.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Baadsgaard M, Quitzau J. Danish registers on personal income and transfer payments. Scand J Public Health. 2011;39(7 Suppl):103–5.

    Article  PubMed  Google Scholar 

  24. Sturmer T, Rothman KJ, Avorn J, et al. Treatment effects in the presence of unmeasured confounding: dealing with observations in the tails of the propensity score distribution–a simulation study. Am J Epidemiol. 2010;172(7):843–54.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Turchiano M, Saunders JK, Fernandez G, et al. Bariatric surgery may improve employment status in unemployed, underserved, severely obese patients. Obes Surg. 2014;24(5):692–5.

    Article  PubMed  Google Scholar 

  26. Riccò M, Marchesi F, Tartamella F, et al. The impact of bariatric surgery on health outcomes, wellbeing and employment rates: analysis from a prospective cohort study. Ann Ig. 2017;29(5):440–52.

    PubMed  Google Scholar 

  27. Mancini A, Borel A-L, Coumes S, et al. Bariatric surgery improves the employment rate in people with obesity: 2-year analysis. Surg Obes Relat Dis. 2018;14(11):1700–4.

    Article  PubMed  Google Scholar 

  28. Hawkins SC, Osborne A, Finlay IG, et al. Paid work increases and state benefit claims decrease after bariatric surgery. Obes Surg. 2007;17(4):434.

    Article  PubMed  Google Scholar 

  29. Durand-Moreau Q, Gautier A, Becouarn G, et al. Employment and professional outcomes in 803 patients undergoing bariatric surgery in a French reference center for obesity. Int J Occup Environ Med. 2015;6(2 April):502–95–103.

  30. Tarride J-E, Breau R, Sharma AM, et al. The effect of bariatric surgery on mobility, health-related quality of life, healthcare resource utilization, and employment status. Obes Surg. 2017;27(2):349–56.

    Article  PubMed  Google Scholar 

  31. Velcu LM, Adolphine R, Mourelo R, et al. Weight loss, quality of life and employment status after Roux-en-Y gastric bypass: 5-year analysis. Surg Obes Relat Dis. 2005;1(4):413–6.

    Article  PubMed  Google Scholar 

  32. Andersen JR, Hernæs UJ, Hufthammer KO, et al. Employment status and sick-leave following obesity surgery: a five-year prospective cohort study. PeerJ. 2015;3:e1285.

  33. Wagner AJ, Fabry JM, Thirlby RC. Return to work after gastric bypass in Medicaid-funded morbidly obese patients. Arch Surg. 2007;142(10):935–40.

    Article  PubMed  Google Scholar 

  34. Sharples AJ, Cheruvu CV. Systematic review and meta-analysis of occupational outcomes after bariatric surgery. Obes Surg. 2017;27(3):774–81.

    Article  PubMed  Google Scholar 

  35. Sjostrom L. Review of the key results from the Swedish Obese Subjects (SOS) trial-a prospective controlled intervention study of bariatric surgery. J Intern Med. 2013;273(3):219–34.

    Article  CAS  PubMed  Google Scholar 

  36. Colquitt JL, Pickett K, Loveman E, et al. Surgery for weight loss in adults. Cochrane Database of Systematic Reviews. 2014(8).

  37. Puhl RM, Luedicke J. Weight-based victimization among adolescents in the school setting: emotional reactions and coping behaviors. J Youth Adolesc. 2012;41(1):27–40.

    Article  PubMed  Google Scholar 

  38. Carr D, Friedman MAJSPQ. Body weight and the quality of interpersonal relationships. 2006;69(2):127-49.

  39. Sikorski C, Luppa M, Luck T, et al. Weight stigma “gets under the skin”-evidence for an adapted psychological mediation framework: a systematic review. Obesity (Silver Spring). 2015;23(2):266–76.

    Article  Google Scholar 

  40. Spahlholz J, Baer N, König HH, et al. Obesity and discrimination–a systematic review and meta‐analysis of observational studies. 2016;17(1):43–55.

  41. Sattler KM, Deane FP, Tapsell L, et al. Gender differences in the relationship of weight-based stigmatisation with motivation to exercise and physical activity in overweight individuals. 2018;5(1):2055102918759691

  42. Fikkan J, Rothblum E, Brownell KD, et al. Weight bias: Nature, consequences, and remedies. 2005.

  43. Best D, Avenell A, Bhattacharya S. How effective are weight-loss interventions for improving fertility in women and men who are overweight or obese? A systematic review and meta-analysis of the evidence. Hum Reprod Update. 2017;23(6):681–705.

    Article  PubMed  Google Scholar 

  44. Guelinckx I, Devlieger R, Vansant G. Reproductive outcome after bariatric surgery: a critical review. Hum Reprod Update. 2009;15(2):189–201.

    Article  PubMed  Google Scholar 

  45. Tack J, Deloose E. Complications of bariatric surgery: dumping syndrome, reflux and vitamin deficiencies. Best Practice Research Clinical Gastroenterology. 2014;28(4):741–9.

    Article  CAS  PubMed  Google Scholar 

  46. Hammer HF. Medical complications of bariatric surgery: focus on malabsorption and dumping syndrome. Dig Dis. 2012;30(2):182–6.

    Article  PubMed  Google Scholar 

  47. Courcoulas AP, King WC, Belle SH, et al. Seven-Year Weight Trajectories and Health Outcomes in the Longitudinal Assessment of Bariatric Surgery (LABS) Study. JAMA Surg. 2018;153(5):427–34.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. National Institute of Public Health, University of Southern Denmark, Studiestræde 6, 1455, Copenhagen K, Denmark

    Maja Bramming, Ulrik Becker, Maja B. Jørgensen & Janne S. Tolstrup

  2. Gastrounit Medical Division, Copenhagen University Hospital Hvidovre, 2650, Hvidovre, Denmark

    Ulrik Becker & Søren Neermark

  3. Health Promotion and Inequality, Danish Health Authority, 2300, Copenhagen S, Denmark

    Maja B. Jørgensen

  4. Center of Planning, Danish Health Authority, 2300, Copenhagen S, Denmark

    Søren Neermark

  5. Zealand University Hospital, Region Zealand, 4600, Køge, Denmark

    Thue Bisgaard

Authors
  1. Maja Bramming
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  2. Ulrik Becker
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  3. Maja B. Jørgensen
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  4. Søren Neermark
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  5. Thue Bisgaard
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  6. Janne S. Tolstrup
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Corresponding author

Correspondence to Janne S. Tolstrup.

Ethics declarations

Ethics Approval

The study was approved by the Danish Data Protection Agency reference number 2015–57-0008. Manual chart review with data collection was performed with the approval of Danish Patient Safety Authority (former National Board of Health) with reference number 3–3013-770/1.

Informed Consent

For this type of study formal consent is not required.

Conflict of Interest

The authors declare no competing interests.

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Key Points

• Women undergoing bariatric surgery had a higher risk of unemployment.

• Men undergoing bariatric surgery had a lower risk of unemployment.

• The risk of sickness absence was higher for both men and women undergoing surgery.

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Bramming, M., Becker, U., Jørgensen, M.B. et al. Bariatric Surgery and Risk of Unemployment and Sickness Absence. OBES SURG 32, 720–728 (2022). https://doi.org/10.1007/s11695-021-05802-2

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  • DOI: https://doi.org/10.1007/s11695-021-05802-2

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