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Published in: Obesity Surgery 8/2009

01-08-2009 | Research

The Impact of Socioeconomic Factors on Patient Preparation for Bariatric Surgery

Authors: Lisa M. Balduf, Geoffrey P. Kohn, Joseph A. Galanko, Timothy M. Farrell

Published in: Obesity Surgery | Issue 8/2009

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Abstract

Background

Socioeconomic factors (SEF) influence bariatric surgery access and outcomes perhaps because of variations in patient knowledge and behaviors. This study examines the associations between income, formal education, race, health insurance, employment status, and patient self-educational and behavioral activities prior to bariatric surgery.

Methods

From March 2005 through January 2006, we surveyed 127 individuals who contacted our office seeking bariatric surgery. Study participants were asked to report their income, formal education, health insurance, employment status, height, weight, and standard demographic data. The type and number of self-educational resources utilized were elicited; a description of current eating and exercise behaviors was obtained; and an objective assessment (OA) of knowledge of the risks of both obesity and bariatric procedures was completed.

Results

The most valuable self-educational resource cited by respondents was the internet (41.2%) and was unaffected by SEF. Individuals who were employed, privately insured, white, and earning ≥$20,000/year reported using a greater number of self-educational resources than their peers, while subjects who were privately insured, had higher formal educational levels, and earned ≥$20,000/year demonstrated greater proficiency on the OA instrument. Engagement in healthy eating and exercise behaviors was unaffected by any SEF. On multivariate analysis, higher income was the sole significant factor directly related to the number of educational resources utilized and proficiency on OA.

Conclusion

Obese patients from lower-income households may benefit from additional preoperative education. All individuals, regardless of socioeconomic factors, must be encouraged to implement healthy eating and exercise behaviors preoperatively.
Literature
1.
go back to reference Chang VW, Lauderdale DS. Income disparities in body mass index and obesity in the United States, 1971–2002. Arch Intern Med. 2005;165(18):2122–8.CrossRef Chang VW, Lauderdale DS. Income disparities in body mass index and obesity in the United States, 1971–2002. Arch Intern Med. 2005;165(18):2122–8.CrossRef
2.
go back to reference Paeratakul S, Lovejoy JC, Ryan DH, et al. The relation of gender, race and socioeconomic status to obesity and obesity comorbidities in a sample of US adults. Int J Obes Relat Metab Disord. 2002;26(9):1205–10.CrossRef Paeratakul S, Lovejoy JC, Ryan DH, et al. The relation of gender, race and socioeconomic status to obesity and obesity comorbidities in a sample of US adults. Int J Obes Relat Metab Disord. 2002;26(9):1205–10.CrossRef
3.
go back to reference 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.CrossRef 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.CrossRef
4.
go back to reference Livingston EH, Ko CY. Socioeconomic characteristics of the population eligible for obesity surgery. Surgery. 2004;135(3):288–96.CrossRef Livingston EH, Ko CY. Socioeconomic characteristics of the population eligible for obesity surgery. Surgery. 2004;135(3):288–96.CrossRef
5.
go back to reference 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.CrossRef 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.CrossRef
6.
go back to reference Flegal KM, Carroll MD, Ogden CL, et al. Prevalence and trends in obesity among US adults, 1999–2000. JAMA. 2002;288(14):1723–7.CrossRef Flegal KM, Carroll MD, Ogden CL, et al. Prevalence and trends in obesity among US adults, 1999–2000. JAMA. 2002;288(14):1723–7.CrossRef
7.
go back to reference 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.CrossRef 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.CrossRef
8.
go back to reference Smoot TM, Xu P, Hilsenrath P, et al. Gastric bypass surgery in the United States, 1998–2002. Am J Public Health. 2006;96(7):1187–9.CrossRef Smoot TM, Xu P, Hilsenrath P, et al. Gastric bypass surgery in the United States, 1998–2002. Am J Public Health. 2006;96(7):1187–9.CrossRef
9.
go back to reference Nguyen NT, Silver M, Robinson M, et al. Result of a national audit of bariatric surgery performed at academic centers: a 2004 University HealthSystem Consortium Benchmarking Project. Arch Surg. 2006;141(5):445–9. discussion 449-50.CrossRef Nguyen NT, Silver M, Robinson M, et al. Result of a national audit of bariatric surgery performed at academic centers: a 2004 University HealthSystem Consortium Benchmarking Project. Arch Surg. 2006;141(5):445–9. discussion 449-50.CrossRef
10.
go back to reference O'Brien PE, Dixon JB, Laurie C, et al. Treatment of mild to moderate obesity with laparoscopic adjustable gastric banding or an intensive medical program: a randomized trial. Ann Intern Med. 2006;144(9):625–33.CrossRef O'Brien PE, Dixon JB, Laurie C, et al. Treatment of mild to moderate obesity with laparoscopic adjustable gastric banding or an intensive medical program: a randomized trial. Ann Intern Med. 2006;144(9):625–33.CrossRef
11.
go back to reference Santry HP, Gillen DL, Lauderdale DS. Trends in bariatric surgical procedures. JAMA. 2005;294(15):1909–17.CrossRef Santry HP, Gillen DL, Lauderdale DS. Trends in bariatric surgical procedures. JAMA. 2005;294(15):1909–17.CrossRef
12.
go back to reference Farrell TM, Haggerty SP, Overby DW, et al. Clinical application of laparoscopic bariatric surgery: an evidence-based review. Surg Endosc. 2009;23(5):930–49.CrossRef Farrell TM, Haggerty SP, Overby DW, et al. Clinical application of laparoscopic bariatric surgery: an evidence-based review. Surg Endosc. 2009;23(5):930–49.CrossRef
13.
go back to reference NIH. Gastrointestinal surgery for severe obesity. Consensus Development Conference Panel. Ann Intern Med. 1991;115(12):956–61.CrossRef NIH. Gastrointestinal surgery for severe obesity. Consensus Development Conference Panel. Ann Intern Med. 1991;115(12):956–61.CrossRef
14.
go back to reference Laville M, Romon M, Chavrier G, et al. Recommendations regarding obesity surgery. Obes Surg. 2005;15(10):1476–80.CrossRef Laville M, Romon M, Chavrier G, et al. Recommendations regarding obesity surgery. Obes Surg. 2005;15(10):1476–80.CrossRef
15.
go back to reference Melissas J. IFSO guidelines for safety, quality, and excellence in bariatric surgery. Obes Surg. 2008;18(5):497–500.CrossRef Melissas J. IFSO guidelines for safety, quality, and excellence in bariatric surgery. Obes Surg. 2008;18(5):497–500.CrossRef
16.
go back to reference Mechanick JI, Kushner RF, Sugerman HJ, et al. American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery Medical Guidelines for Clinical Practice for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient. Surg Obes Relat Dis. 2008;4(5 Suppl):S109–84.CrossRef Mechanick JI, Kushner RF, Sugerman HJ, et al. American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery Medical Guidelines for Clinical Practice for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient. Surg Obes Relat Dis. 2008;4(5 Suppl):S109–84.CrossRef
17.
go back to reference Carbonell AM, Lincourt AE, Matthews BD, et al. National study of the effect of patient and hospital characteristics on bariatric surgery outcomes. Am Surg. 2005;71(4):308–14.PubMed Carbonell AM, Lincourt AE, Matthews BD, et al. National study of the effect of patient and hospital characteristics on bariatric surgery outcomes. Am Surg. 2005;71(4):308–14.PubMed
18.
go back to reference Hamoui N, Lake J, Beart RW, et al. Patterns of internet use: bariatric versus colorectal patients in a private institution. J Am Coll Surg. 2004;199(2):223–8.CrossRef Hamoui N, Lake J, Beart RW, et al. Patterns of internet use: bariatric versus colorectal patients in a private institution. J Am Coll Surg. 2004;199(2):223–8.CrossRef
19.
go back to reference Makar B, Quilliot D, Zarnegar R, et al. What is the quality of information about bariatric surgery on the internet? Obes Surg. 2008;18(11):1455–9.CrossRef Makar B, Quilliot D, Zarnegar R, et al. What is the quality of information about bariatric surgery on the internet? Obes Surg. 2008;18(11):1455–9.CrossRef
20.
go back to reference Salant T, Santry HP. Internet marketing of bariatric surgery: contemporary trends in the medicalization of obesity. Soc Sci Med. 2006;62(10):2445–57.CrossRef Salant T, Santry HP. Internet marketing of bariatric surgery: contemporary trends in the medicalization of obesity. Soc Sci Med. 2006;62(10):2445–57.CrossRef
21.
go back to reference Madan AK, Frantzides CT, Pesce CE. The quality of information about laparoscopic bariatric surgery on the Internet. Surg Endosc. 2003;17(5):685–7.CrossRef Madan AK, Frantzides CT, Pesce CE. The quality of information about laparoscopic bariatric surgery on the Internet. Surg Endosc. 2003;17(5):685–7.CrossRef
Metadata
Title
The Impact of Socioeconomic Factors on Patient Preparation for Bariatric Surgery
Authors
Lisa M. Balduf
Geoffrey P. Kohn
Joseph A. Galanko
Timothy M. Farrell
Publication date
01-08-2009
Publisher
Springer New York
Published in
Obesity Surgery / Issue 8/2009
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-009-9889-4

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