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Low socioeconomic status is associated with lower weight-loss outcomes 10-years after Roux-en-Y gastric bypass

  • Anthony Carden
  • Kelly Blum
  • Carlie J. Arbaugh
  • Amber Trickey
  • Dan Eisenberg
Article

Abstract

Background

Roux-en-Y gastric bypass (RYGB) is the criterion standard operation for weight loss. Low socioeconomic status (SES) is common in the Veteran population undergoing bariatric surgery, but the impact of SES on long-term weight-loss outcomes is not known. We hypothesize that low socioeconomic status is associated with less weight loss after gastric bypass in long-term follow-up.

Methods

We performed a retrospective review of patients undergoing RYGB at a single Veterans Affairs (VA) hospital. Patients with at least 10 years of follow-up data in the electronic health record were included in the analysis. Weight loss was measured as percent excess body mass index loss (%EBMIL). The primary predictor variable, median household income, was determined using zip codes of patient residences matched to publicly available 2010 U.S. census data. Univariate relationships between income, weight loss, and other patient characteristics were evaluated. We calculated a multivariate generalized linear model of %EBMIL to estimate independent relationships with median household income quartile while controlling for patients’ age, race, sex, and VA distance.

Results

Complete 10-year follow-up data were available for 83 of 92 patients (90.2%) who underwent RYGB between 2001 and 2007 and survived at least 10 years. The majority of patients were male (79.5%) and white (73.5%). The mean 10-year %EBMIL was 57.8% (SD: 29.5%, range − 36.0% − 132.8%). In univariate analysis, income was significantly associated with race (p < 0.001) and median distance to the VA bariatric center (p = 0.034), but income did not differ by gender (p = 0.73) or age (p = 0.45). Multivariate analysis revealed significantly lower 10-year %EBMIL for patients with the lowest income compared to patients with low-mid income (p = 0.03) and mid-high income (p = 0.01), after controlling for gender, race, age, and VA distance.

Conclusions

Low socioeconomic status is associated with lower weight-loss outcomes, 10 years after RYGB. Durable weight loss is observed in all income groups.

Keywords

Roux-en-y Gastric Bypass (RYGB) Socioeconomic status Veterans Affairs (VA) Bariatric Long-term outcomes 

Notes

Compliance with ethical standards

Disclosures

Anthony Carden, Kelly Blum, Carlie Arbaugh, Amber Trickey, and Dan Eisenberg have no conflicts of interest or financial ties to disclose.

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Copyright information

© This is a U.S. government work and its text is not subject to copyright protection in the United States; however, its text may be subject to foreign copyright protection 2018

Authors and Affiliations

  • Anthony Carden
    • 1
  • Kelly Blum
    • 2
  • Carlie J. Arbaugh
    • 3
  • Amber Trickey
    • 2
  • Dan Eisenberg
    • 1
    • 2
  1. 1.Surgical ServicesPalo Alto VA Health Care SystemPalo AltoUSA
  2. 2.Department of Surgery and Stanford-Surgery Policy Improvement Research and Education (S-SPIRE) CenterStanford University School of MedicineStanfordUSA
  3. 3.Stanford School of MedicineStanfordUSA

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