Patient race and the likelihood of undergoing bariatric surgery among patients seeking surgery
Ethnic minority adults have disproportionately higher rates of obesity than Caucasians but are less likely to undergo bariatric surgery. Recent data suggest that minorities might be less likely to seek surgery. Whether minorities who seek surgery are also less likely to proceed with surgery is unclear.
We interviewed 651 patients who sought bariatric surgery at two academic medical centers to examine whether ethnic minorities are less likely to proceed with surgery than Caucasians and whether minorities who do proceed with surgery have higher illness burden than their counterparts. We collected patient demographics and abstracted clinical data from the medical records. We then conducted multivariable analyses to examine the association between race and the likelihood of proceeding with bariatric surgery within 1 year of initial interview and to compare the illness burden by race and ethnicity among those who underwent surgery.
Of our study sample, 66 % were Caucasian, 18 % were African-American, and 12 % were Hispanics. After adjustment for socioeconomic factors, there were no racial differences in who proceeded with bariatric surgery. Among those who proceeded with surgery, illness burden was comparable between minorities and Caucasian patients with the exception that African-Americans were underrepresented among those with reflux disease (0.4, 95 % CI 0.2–0.7) and depression (0.4, 0.2–0.7), and overrepresented among those with anemia (4.8, 2.4–9.6) than Caucasian patients.
Race and ethnicity were not independently associated with likelihood of proceeding with bariatric surgery. Minorities who proceeded with surgery did not clearly have higher illness burden than Caucasian patients.
KeywordsBariatric surgery Obesity Insurance coverage Vulnerable populations Social class Ethnic minorities
The study was funded by a grant from the National Institutes of Health (R01DK073302, PI Wee). Dr. Wee is also supported by a NIH Midcareer Mentorship Award (K24DK087932). The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript. Ms. Chiodi has full access to the data and takes responsibility for the integrity and accuracy of the data.
Drs. Stanford, Schneider, Blackburn, Apovian, Hess, Wee, Ms. Chiodi, Robert, and Bourland have no conflicts of interest or financial ties to disclose. Dr. Jones a consultant for Allurion, a satiety device company.
- 8.Wee CC, Hamel MB, Apovian CM, Blackburn GL, Bolcic-Jankovic D, Colten ME, Hess DT, Huskey KW, Marcantonio ER, Schneider BE, Jones DB (2013) Expectations for weight loss and willingness to accept risk among patients seeking weight loss surgery. JAMA Surg 148(3):264–271PubMedCentralCrossRefPubMedGoogle Scholar