Social vulnerability impacts weight loss in adolescents 10 years after bariatric surgery
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Key takeaways:
- Societal factors may influence the long-term effectiveness of metabolic and bariatric surgery.
- At 10 years, adolescents residing in low vulnerability areas had greater BMI loss after surgery.
DALLAS — Social vulnerability appears to attenuate weight loss at 10 years among adolescents who underwent metabolic and bariatric surgery, researchers reported at ObesityWeek.
“While early weight loss [after] metabolic and bariatric surgery in adolescents with severe obesity has been established, there is a need to explore social factors,” Richard E. Boles, PhD, professor at the University of Colorado Anschutz Medical Center, said during a presentation. “We aimed to examine the relation of social vulnerability and BMI” through 10 years of follow-up.
The researchers analyzed data from 274 adolescents (≤ 19 years) who underwent Roux-en-Y gastric bypass or vertical sleeve gastrectomy at five U.S. centers from 2007 to 2012 in the prospective observational Teen-LABS study. Boles and colleagues linked residential addresses of 239 participants to the CDC’s 2010 Social Vulnerability Index, which assesses 14 factors including unemployment, housing and transportation, and then categorized adolescents into low or high social vulnerability groups. The researchers then examined the relationship between social vulnerability group and change in BMI over 10 years.
At the study outset, 55% of participants lived in high vulnerability areas. Non-white and Hispanic participants were more likely to reside in high vulnerability locations (P < .05 for each).
Baseline BMI was similar, at 51 kg/m2 in the low social vulnerability group and 53 kg/m2 in the high social vulnerability group (P = .25).
Participants residing in low vulnerability areas had greater BMI loss over the first 10 years after surgery compared with those residing in higher vulnerability areas (P = .04), according to adjusted analyses. At 10 years, BMI loss was –23% (95% CI, –27 to –20)in the low vulnerability group compared with –19% (95% CI, –22 to –16) in the high vulnerability group, according to the results.
“In the first 10 years postoperatively, those residing in more vulnerable areas at baseline had greater BMI loss compared to those in higher vulnerable areas,” Boles said. “We think this is certainly related to a constellation of factors that are comprised in that social vulnerability index.”
Overall, the researchers said the findings suggest that adolescents living in areas with fewer opportunities and social risk factors have increased risk for health issues including obesity and also have greater risk for worse long-term outcomes following metabolic and bariatric surgery.
Boles said future directions for research include exploring specific factors that interact with social vulnerability, such as exposure to weight bias and stigma, and developing and testing interventions to prevent weight regain or minimal response after metabolic and bariatric surgery.
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Boles R, et al. Oral-021. Presented at: ObesityWeek; Oct. 14-17, 2023; Dallas.
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