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Obesity Surgery
Published in: Obesity Surgery 12/2014

01-12-2014 | Original Contributions

Is Social Deprivation Associated with Weight Loss Outcomes Following Bariatric Surgery? A 10-Year Single Institutional Experience

Authors: Maryam Alfa Wali, Hutan Ashrafian, Kerry L. Schofield, Leanne Harling, Abdullah Alkandari, Ara Darzi, Thanos Athansiou, Evangelos Efthimiou

Published in: Obesity Surgery | Issue 12/2014

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Abstract

Background

Social deprivation is associated with a greater morbidity and shorter life expectancy. This study evaluates differences in weight loss following bariatric surgery and deprivation, based on UK deprivation measures in a London bariatric centre.

Methods

All patients undergoing bariatric surgery between 2002 and 2012 were retrospectively identified. Demographic details, type of surgery and percentage excess weight loss data were collected. UK Index of Multiple Deprivation (IMD, 2010) and IMD domain of the Health Deprivation and Disability (HDD) scores were used to assess deprivation (where 1 is the most deprived in rank order and 32,482 is the least deprived). Two-way between-subjects analysis of variance (ANOVA) was performed to examine the effect of IMD score, deprivation, procedure type and gender on percentage excess weight loss.

Results

Data were included from 983 patients (178 male, 805 female) involving 3,663 patient episodes. Treatments comprised laparoscopic gastric bands (n = 533), gastric bypass (n = 362) and gastric balloons (n = 88). The average percentage excess weight loss across all procedures was 38 % over a follow-up period (3 months–9 years). There was no correlation between weight loss and IMD/HDD rank scores. Gastric bypass was significantly more effective at achieving weight loss than the other two procedures at 3-, 6- and 9-month and 1-year follow-up.

Conclusions

Social deprivation does not influence weight loss after bariatric surgery, suggesting that all socioeconomic groups may equally benefit from surgical intervention. Social deprivation should not therefore negatively influence the decision for surgical intervention in these patients.
Literature
1.
2.
Ashrafian H, le Roux CW, Darzi A, et al. Effects of bariatric surgery on cardiovascular function. Circulation. 2008;118(20):2091–102.PubMedCrossRef
3.
Ashrafian H, le Roux CW, Rowland SP, et al. Metabolic surgery and obstructive sleep apnoea: the protective effects of bariatric procedures. Thorax. 2012;67(5):442–9.PubMedCrossRef
4.
Ashrafian H, Ahmed K, Rowland SP, et al. Metabolic surgery and cancer: protective effects of bariatric procedures. Cancer. 2011;117(9):1788–99.PubMedCrossRef
5.
Ashrafian H, Athanasiou T, le Roux CW. Heart remodelling and obesity: the complexities and variation of cardiac geometry. Heart. 2011;97(3):171–2.PubMedCrossRef
6.
7.
Fenske W, Athanasiou T, Harling L, et al. Obesity-related cardiorenal disease: the benefits of bariatric surgery. Nat Rev Nephrol. 2013;9(9):539–51.PubMedCrossRef
8.
Ashrafian H, Harling L, Darzi A, et al. Neurodegenerative disease and obesity: what is the role of weight loss and bariatric interventions? Metab Brain Dis. 2013;28(3):341–53.PubMedCrossRef
9.
Ashrafian H, Athanasiou T, Li JV, et al. Diabetes resolution and hyperinsulinaemia after metabolic Roux-en-Y gastric bypass. Obes Rev : An Offic J Int Assoc Study Obes. 2011;12(5):e257–72.CrossRef
10.
11.
Kelly T, Yang W, Chen CS, et al. Global burden of obesity in 2005 and projections to 2030. Int J Obes (Lond). 2008;32(9):1431–7.CrossRef
12.
Janssen I, Boyce WF, Simpson K, et al. Influence of individual- and area-level measures of socioeconomic status on obesity, unhealthy eating, and physical inactivity in Canadian adolescents. Am J Clin Nutr. 2006;83(1):139–45.PubMed
13.
Stafford M, Brunner EJ, Head J, et al. Deprivation and the development of obesity a multilevel, longitudinal study in England. Am J Prev Med. 2010;39(2):130–9.PubMedCrossRef
14.
Korda RJ, Joshy G, Jorm LR, et al. Inequalities in bariatric surgery in Australia: findings from 49,364 obese participants in a prospective cohort study. Med J Aust. 2012;197(11):631–6.PubMedCrossRef
15.
Martin M, Beekley A, Kjorstad R, et al. Socioeconomic disparities in eligibility and access to bariatric surgery: a national population-based analysis. Surg Obes Relat Dis. 2010;6(1):8–15.PubMedCrossRef
16.
Livingston EH, Ko CY. Socioeconomic characteristics of the population eligible for obesity surgery. Surgery. 2004;135(3):288–96.PubMedCrossRef
17.
Leiva MJ, Fuentealba C, Boggiano C, et al. Quality of life of patients subjected to gastric bypass more than one year ago: influence of socioeconomic status. Rev Med Chil. 2009;137(5):625–33.PubMedCrossRef
18.
Martin LF, Tan TL, Holmes PA, et al. Preoperative insurance status influences postoperative complication rates for gastric bypass. Am J Surg. 1991;161(6):625–34.PubMedCrossRef
19.
Dallal RM, Bailey L, Guenther L, et al. Comparative analysis of short-term outcomes after bariatric surgery between two disparate populations. Surg Obes Relat Dis. 2008;4(2):110–4.PubMedCrossRef
20.
Hatoum IJ, Stein HK, Merrifield BF, et al. Capacity for physical activity predicts weight loss after Roux-en-Y gastric bypass. Obesity (Silver Spring). 2009;17(1):92–9.CrossRef
21.
Ketchum ES, Morton JM. Disappointing weight loss among shift workers after laparoscopic gastric bypass surgery. Obes Surg. 2007;17(5):581–4.PubMedCrossRef
22.
Alexander JW, Goodman HR, Martin Hawver LR, et al. The impact of medicaid status on outcome after gastric bypass. Obes Surg. 2008;18(10):1241–5.PubMedCrossRef
23.
Durkin AJ, Bloomston M, Murr MM, et al. Financial status does not predict weight loss after bariatric surgery. Obes Surg. 1999;9(6):524–6.PubMedCrossRef
24.
25.
26.
NICE. Guidance on the use of surgery to aid weight reduction for people with morbid obesity: technology appraisal guidance no. 46. 2002.
27.
NICE. Obesity: the prevention, identification, assessment and management of overweight and obesity in adults and children. 2006.
28.
Government CaL. English indices of deprivation 2010: guidance. In: government CaL, editor. 2011.
29.
Mingrone G, Panunzi S, De Gaetano A, et al. Bariatric surgery versus conventional medical therapy for type 2 diabetes. N Engl J Med. 2012;366(17):1577–85.PubMedCrossRef
30.
Schauer PR, Kashyap SR, Wolski K, et al. Bariatric surgery versus intensive medical therapy in obese patients with diabetes. N Engl J Med. 2012;366(17):1567–76.PubMedCentralPubMedCrossRef
31.
Sjostrom L, Lindroos AK, Peltonen M, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351(26):2683–93.PubMedCrossRef
32.
Sjöström L, Narbro K, Sjöström CD, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357(8):741–52.PubMedCrossRef
33.
Ashrafian H, Bueter M, Ahmed K, et al. Metabolic surgery: an evolution through bariatric animal models. Obes Rev : An Offic J Int Assoc Study Obes. 2010;11(12):907–20.CrossRef
34.
Ashrafian H, le Roux CW. Metabolic surgery and gut hormones—a review of bariatric entero-humoral modulation. Physiol Behav. 2009;97(5):620–31.PubMedCrossRef
35.
36.
Wallace AE, Young-Xu Y, Hartley D, et al. Racial, socioeconomic, and rural-urban disparities in obesity-related bariatric surgery. Obes Surg. 2010;20(10):1354–60.PubMedCrossRef
37.
Owen-Smith A, Kipping R, Donovan J, et al. A NICE example? Variation in provision of bariatric surgery in England. BMJ. 2013;346:f2453.PubMedCrossRef
38.
RightCare. The NHS atlas of variation in healthcare. 2011
Metadata
Title
Is Social Deprivation Associated with Weight Loss Outcomes Following Bariatric Surgery? A 10-Year Single Institutional Experience
Authors
Maryam Alfa Wali
Hutan Ashrafian
Kerry L. Schofield
Leanne Harling
Abdullah Alkandari
Ara Darzi
Thanos Athansiou
Evangelos Efthimiou
Publication date
01-12-2014
Publisher
Springer US
Published in
Obesity Surgery / Issue 12/2014
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-014-1290-2

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