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Sex, Race, and the Quality of Life Factors Most Important to Patients’ Well-Being Among Those Seeking Bariatric Surgery

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Abstract

Background

Evidence suggests obesity-related social stigma and impairment in work function may be the two most detrimental quality of life (QOL) factors to overall well-being among patients seeking weight loss surgery (WLS); whether the relative importance of QOL factors varies across patient sex and race/ethnicity is unclear.

Methods

We interviewed 574 patients seeking WLS at two centers. We measured patient’s health utility (preference-based well-being measure) as determined via standard gamble scenarios assessing patients’ willingness to risk death to achieve weight loss or perfect health. Multivariable models assessed associations between patients’ utility and five weight-related QOL domains stratified by gender and race: social stigma, self-esteem, physical function, public distress (weight stigma), and work life.

Results

Depending on patients’ sex and race/ethnicity, mean utilities ranged from 0.85 to 0.91, reflecting an average willingness to assume a 9–15 % risk of death to achieve their most desired health/weight state. After adjustment, African Americans (AAs) reported higher utility than Caucasians (+0.054, p = 0.03), but utilities did not vary significantly by sex. Among Caucasian and AA men, impairment in physical functioning was the most important factor associated with diminished utility; social stigma was also a leading factor for Caucasian men. Among Caucasian women, self-esteem and work function appeared equally important. Social stigma was the leading contributor to utility among AA women; QOL factors did not appear as important among Hispanic patients.

Conclusion

AAs reported higher utilities than Caucasian patients. Individual QOL domains that drive diminished well-being varied across race/ethnicity and sex.

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Acknowledgments

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. Huskey had full access to the data and takes responsibility for the integrity and accuracy of the data.

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Authors and Affiliations

  1. Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA, 02215, USA

    Christina C. Wee, Roger B. Davis, Sarah Chiodi, Karen W. Huskey & Mary B. Hamel

  2. Division of Minimally Invasive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA

    Dan B. Jones

  3. Evans Department of Medicine and Department of Surgery, Boston Medical Center, Boston, MA, USA

    Caroline A. Apovian

Authors
  1. Christina C. Wee
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  2. Roger B. Davis
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  3. Dan B. Jones
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  4. Caroline A. Apovian
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  5. Sarah Chiodi
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  6. Karen W. Huskey
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  7. Mary B. Hamel
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Corresponding author

Correspondence to Christina C. Wee.

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Funding

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).

Conflict of Interest

Dr. Apovian reports grants from National Institutes of Health, from Myos, from Aspire Bariatrics, and from GI Dynamics; grants and personal fees from Amylin, from Sanofi-Aventis, from Orexigen, and from Takeda; personal fees from Merck, from Johnson & Johnson, from Arena, from Nutrisystem, from Zafgen, from EnteroMedics, and from NovoNordisk for work unrelated to the current project. All other authors declare they have no conflict of interest.

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Wee, C.C., Davis, R.B., Jones, D.B. et al. Sex, Race, and the Quality of Life Factors Most Important to Patients’ Well-Being Among Those Seeking Bariatric Surgery. OBES SURG 26, 1308–1316 (2016). https://doi.org/10.1007/s11695-015-1956-4

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  • DOI: https://doi.org/10.1007/s11695-015-1956-4

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