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Men, blacks less likely to consider bariatric surgery
Blacks and men were less likely to consider bariatric surgery and to have been recommended surgery by their physicians, according to study findings published in the Journal of General Internal Medicine.
“It’s been assumed that the racial barrier to weight-loss surgery is economic, that people don’t have insurance, are underinsured or can’t afford the co-pay or the time off work and that’s why we don’t see certain groups seeking treatment,” Christina Wee, MD, MPH, associate section chief for research in the division of general medicine and primary at Beth Israel Deaconess Medical Center, said in a press release. “But, in fact, the patients we talked to rarely mentioned economic barriers, so that didn’t account for (the) twofold difference between Caucasian and African Americans.”
Christina Wee
The researchers conducted a telephone interview of 337 patients with a BMI >35 who were seen at four diverse primary care practices in the Boston area to evaluate their considerations of bariatric surgery, according to data.
Of the 325 patients who reported they had heard of bariatric surgery, only 34% had seriously considered it, according to data. In addition, men were less likely than women and blacks were less likely than whites to consider surgery after adjustments for sociodemographics and BMI.
However, the adjustments did not explain the sex or racial differences, according to Wee.
“What we found is that a significant reason that more African Americans have not considered weight-loss surgery is that obesity has not diminished their quality of life as much as it has diminished quality of life for Caucasians,” Wee said in the press release.
Physician recommendations for bariatric surgery were independently tied to serious considerations for surgery (OR=4.95; 95% CI, 2.81-8.7), according to data.
Patients said they were more likely to consider surgery if their clinician were to recommend it, according to researchers. However, only 20% of patients reported such a recommendation by their clinician.
“Quality of life is clearly a very important motivator to patients with obesity. And what this study shows is that those quality-of-life differences across race are so important that they may actually drive decision-making in a way that creates racial differences in how people think about undergoing treatment,” Wee said. “It speaks to the importance of thinking about the whole patient, factoring in personal values and facilitating individualized decision-making.”
Disclosure: Wee is supported by an NIH Midcareer Mentorship Award (K24DK087932). All other researchers report no relevant financial disclosures.