Surgical Endoscopy

, Volume 27, Issue 12, pp 4556–4563 | Cite as

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

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



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.


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.


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).


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.


Male comorbidities Metabolic syndrome Bariatric surgery Diabetes Hypertension Obesity 



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


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


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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Gina N. Farinholt
    • 1
  • Aaron D. Carr
    • 1
  • Eun Jin Chang
    • 1
  • Mohamed R. Ali
    • 1
  1. 1.Department of SurgeryUniversity of California, DavisSacramentoUSA

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