Obesity Surgery

, Volume 25, Issue 5, pp 888–899 | Cite as

Inequity to the Utilization of Bariatric Surgery: a Systematic Review and Meta-Analysis

  • Sanjit K. Bhogal
  • Jacinta I. Reddigan
  • Ori D. Rotstein
  • Ashley Cohen
  • Dresden Glockler
  • Andrea C. Tricco
  • Janet K. Smylie
  • Stephen A. Glazer
  • Jason Pennington
  • Lesley Gotlib Conn
  • Timothy D. JacksonEmail author
Review Article


This systematic review explores the sociodemographic factors associated with the utilization of bariatric surgery among eligible patients. Electronic databases were searched for population-based studies that explored the relationship between sociodemographic characteristics of patients eligible for bariatric surgery to those who actually received the procedure. Twelve retrospective cohort studies were retrieved, of which the results of 9 studies were pooled using a random effects model. Patients who received bariatric surgery were significantly more likely to be white versus non-white (OR 1.54; 95 % CI 1.08, 2.19), female versus male (OR 2.80; 95 % CI 2.46, 3.22), and have private versus government or public insurance (OR 2.51; 95 % CI 1.04, 6.05). Prospective cohort studies are warranted to further determine the relative effect of these factors, adjusting for confounding factors.


Bariatric surgery Obesity Sociodemographic disparities Inequity Utilization Systematic review Meta-analysis 



We thank Christine Neilson for the literature search and ongoing library support, and Kevin Thorpe for statistical advice.


This systematic review is funded by the Department of Surgery, St. Michael’s Hospital. ACT is funded by a CIHR New Investigator Award in Knowledge Synthesis.

Author’s Contributions

SKB collaborated in the development of the study protocol, study selection, data abstraction, methodology assessment, data management and entry, data interpretation, and writing of the final manuscript. JIR collaborated in the design of the study, development of the study protocol, study selection, data abstraction, methodology assessment, data management and entry, data interpretation, and writing of the final manuscript. ODR conceived of the study, collaborated in the design of the study, development of the protocol, data interpretation, and writing of the final manuscript. AC was responsible for the analysis, collaborated in data interpretation, assisted in writing of the manuscript, and critically reviewed the manuscript for important statistical content. DG collaborated in the development of the study protocol, study selection, data abstraction, and methodology assessment. ACT collaborated in data interpretation, assisted in the writing of the manuscript, and critically reviewed the manuscript for important methodological content. JKS collaborated in the design of the study, protocol development, and data interpretation. SAG collaborated in the interpretation of the results. JP collaborated in the design of the study, protocol development, and data interpretation. LGC collaborated in the design of the study, development of the study protocol, and data interpretation. TJ collaborated in the design of the study, development of the study protocol, data interpretation, and supervised the overall development, and writing of the study. All authors read and approved the final manuscript.

Conflict of Interest

The authors declare that they have no conflict of interest.

Supplementary material

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ESM 1 (DOCX 34 kb)
11695_2015_1595_MOESM2_ESM.docx (32 kb)
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11695_2015_1595_MOESM3_ESM.docx (30 kb)
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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Sanjit K. Bhogal
    • 1
  • Jacinta I. Reddigan
    • 1
  • Ori D. Rotstein
    • 1
    • 2
  • Ashley Cohen
    • 3
  • Dresden Glockler
    • 4
  • Andrea C. Tricco
    • 5
  • Janet K. Smylie
    • 6
  • Stephen A. Glazer
    • 7
  • Jason Pennington
    • 8
  • Lesley Gotlib Conn
    • 9
  • Timothy D. Jackson
    • 10
    Email author
  1. 1.Department of SurgerySt. Michael’s HospitalTorontoCanada
  2. 2.Keenan Research Centre of the Li Ka Shing Knowledge InstituteSt. Michael’s HospitalTorontoCanada
  3. 3.Applied Health Research Centre of the Li Ka Shing Knowledge InstituteSt. Michael’s HospitalTorontoCanada
  4. 4.University of Western OntarioLondonCanada
  5. 5.Li Ka Shing Knowledge InstituteSt. Michael’s HospitalTorontoCanada
  6. 6.Centre for Research on Inner City HealthSt. Michael’s HospitalTorontoCanada
  7. 7.Bariatric ProgramHumber River Regional HospitalTorontoCanada
  8. 8.Division of General SurgeryThe Scarborough HospitalTorontoCanada
  9. 9.Sunnybrook Research InstituteTorontoCanada
  10. 10.Division of General SurgeryUniversity Health NetworkTorontoCanada

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