Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Obesity Surgery
Published in: Obesity Surgery 4/2015

01-04-2015 | Original Contributions

Association of Race and Socioeconomic Status with Outcomes Following Laparoscopic Roux-en-Y Gastric Bypass

Authors: Allison A. Gullick, Laura A. Graham, Joshua Richman, Manasi Kakade, Richard Stahl, Jayleen Grams

Published in: Obesity Surgery | Issue 4/2015

Login to get access

Abstract

Background

Obesity poses serious health consequences, and bariatric surgery remains the most effective and durable treatment. The goal of this study was to identify the association of race and socioeconomic characteristics with clinical outcomes following laparoscopic Roux-en-Y gastric bypass (LRYGB).

Methods

A retrospective review of all patients who underwent LRYGB between 2004 and 2010 was conducted. Outcomes analyzed included percent excess weight loss (%EWL), percent weight loss (%WL), change in body mass index (ΔBMI), and improvement or remission of obesity-associated medical conditions.

Results

In total, 663 patients met inclusion criteria with 170 (25.6 %) African Americans and 493 (74.4 %) European Americans. When compared to European Americans, the African American group included significantly more women and had a significantly higher preoperative BMI and lower socioeconomic status. In adjusted analyses, African Americans had significantly lower %EWL, %WL, and ΔBMI than the European Americans at 1-, 2-, and 5-year intervals of follow-up. Adjusted spline models including all follow-up visits for all patients also demonstrated a significant difference between the races in %EWL, %WL, and ΔBMI. Both races had similar improvement or remission of type 2 diabetes mellitus, obstructive sleep apnea, hyperlipidemia, and hypertension.

Conclusion

Although African Americans had a statistically significant lower %EWL, %WL, and ΔBMI, both groups had durable weight loss and comparable rates of improvement or remission of obesity-associated comorbidities. Thus, both groups have significant improvement in their overall health after LRYGB.
Literature
1.
Ogden CL, Carroll MD, Kit BK, et al. Prevalence of childhood and adult obesity in the United States, 2011–2012. JAMA. 2014;311(8):806–14.CrossRefPubMed
2.
Sturm R, Hattori A. Morbid obesity rates continue to rise rapidly in the United States. Int J Obes (Lond). 2013;37(6):889–91.CrossRef
3.
Nguyen NT, Masoomi H, Magno CP, et al. Trends in use of bariatric surgery, 2003–2008. J Am Coll Surg. 2011;213(2):261–6.CrossRefPubMed
4.
Spivak H, Abdelmelek MF, Beltran OR, et al. Long-term outcomes of laparoscopic adjustable gastric banding and laparoscopic Roux-en-Y gastric bypass in the United States. Surg Endosc. 2012;26(7):1909–19.CrossRefPubMed
5.
Sjostrom L, Narbro K, Sjostrom CD, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357(8):741–52.CrossRefPubMed
6.
Pournaras DJ, Osborne A, Hawkins SC, et al. Remission of type 2 diabetes after gastric bypass and banding: mechanisms and 2 year outcomes. Ann Surg. 2010;252(6):966–71.CrossRefPubMed
7.
Rasheid S, Banasiak M, Gallagher SF, et al. Gastric bypass is an effective treatment for obstructive sleep apnea in patients with clinically significant obesity. Obes Surg. 2003;13(1):58–61.CrossRefPubMed
8.
Varela JE, Hinojosa MW, Nguyen NT. Resolution of obstructive sleep apnea after laparoscopic gastric bypass. Obes Surg. 2007;17(10):1279–82.CrossRefPubMed
9.
Jamal M, Wegner R, Heitshusen D, et al. Resolution of hyperlipidemia follows surgical weight loss in patients undergoing Roux-en-Y gastric bypass surgery: a 6-year analysis of data. Surg Obes Relat Dis. 2011;7(4):473–9.CrossRefPubMed
10.
Flum DR, Dellinger EP. Impact of gastric bypass operation on survival: a population-based analysis. J Am Coll Surg. 2004;199(4):543–51.CrossRefPubMed
11.
Sjostrom L, Peltonen M, Jacobson P, et al. Association of bariatric surgery with long-term remission of type 2 diabetes and with microvascular and macrovascular complications. JAMA. 2014;311(22):2297–304.CrossRefPubMed
12.
13.
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.CrossRefPubMedCentralPubMed
14.
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.CrossRefPubMed
15.
Schauer PR, Bhatt DL, Kirwan JP, et al. Bariatric surgery versus intensive medical therapy for diabetes—3-year outcomes. N Engl J Med. 2014;370(21):2002–13.CrossRefPubMed
16.
Brancati FL, Kao WH, Folsom AR, et al. Incident type 2 diabetes mellitus in African American and white adults: the atherosclerosis risk in communities study. JAMA. 2000;283(17):2253–9.CrossRefPubMed
17.
3rd Mainous AG, Johnson SP, Saxena SK, et al. Inpatient bariatric surgery among eligible black and white men and women in the United States, 1999–2010. Am J Gastroenterol. 2013;108(8):1218–23.CrossRefPubMed
18.
Harvin G, DeLegge M, Garrow DA. The impact of race on weight loss after Roux-en-Y gastric bypass surgery. Obes Surg. 2008;18(1):39–42.CrossRefPubMed
19.
Anderson WA, Greene GW, Forse RA, et al. Weight loss and health outcomes in African Americans and whites after gastric bypass surgery. Obesity (Silver Spring). 2007;15(6):1455–63.CrossRef
20.
Wang Y, Beydoun MA. The obesity epidemic in the United States—gender, age, socioeconomic, racial/ethnic, and geographic characteristics: a systematic review and meta-regression analysis. Epidemiol Rev. 2007;29:6–28.CrossRefPubMed
21.
Sudan R, Winegar D, Thomas S, et al. Influence of ethnicity on the efficacy and utilization of bariatric surgery in the USA. J Gastrointest Surg. 2014;18(1):130–6.CrossRefPubMed
22.
Tiwari MM, Goede MR, Reynoso JF, et al. Differences in outcomes of laparoscopic gastric bypass. Surg Obes Relat Dis. 2011;7(3):277–82.CrossRefPubMed
23.
Nguyen GC, Patel AM. Racial disparities in mortality in patients undergoing bariatric surgery in the U.S.A. Obes Surg. 2013;23(10):1508–14.CrossRefPubMed
24.
West DS, Elaine Prewitt T, Bursac Z, et al. Weight loss of black, white, and Hispanic men and women in the diabetes prevention program. Obesity (Silver Spring). 2008;16(6):1413–20.CrossRef
25.
Wang X, You T, Lenchik L, et al. Resting energy expenditure changes with weight loss: racial differences. Obesity (Silver Spring). 2010;18(1):86–91.CrossRef
26.
Pickett-Blakely OE, Huizinga MM, Clark JM. Sociodemographic trends in bariatric surgery utilization in the USA. Obes Surg. 2012;22(5):838–42.CrossRefPubMed
27.
Yaemsiri S, Olson EC, He K, et al. Food concern and its associations with obesity and diabetes among lower-income New Yorkers. Public Health Nutr. 2012;15(1):39–47.CrossRefPubMed
28.
Miles R, Panton L. The influence of the perceived quality of community environments on low-income women’s efforts to walk more. J Community Health. 2006;31(5):379–92.CrossRefPubMed
29.
Melton GB, Steele KE, Schweitzer MA, et al. Suboptimal weight loss after gastric bypass surgery: correlation of demographics, comorbidities, and insurance status with outcomes. J Gastrointest Surg. 2008;12(2):250–5.CrossRefPubMed
30.
Lutfi R, Torquati A, Sekhar N, et al. Predictors of success after laparoscopic gastric bypass: a multivariate analysis of socioeconomic factors. Surg Endosc. 2006;20(6):864–7.CrossRefPubMed
31.
Sobal J, Rauschenbach B, Frongillo EA. Marital status changes and body weight changes: a US longitudinal analysis. Soc Sci Med. 2003;56(7):1543–55.CrossRefPubMed
32.
Lopez RP. Neighborhood risk factors for obesity. Obesity (Silver Spring). 2007;15(8):2111–9.CrossRef
33.
Weng HH, Bastian LA, Taylor Jr DH, et al. Number of children associated with obesity in middle-aged women and men: results from the health and retirement study. J Womens Health (Larchmt). 2004;13(1):85–91.CrossRef
34.
Diez-Roux AV, Kiefe CI, Jacobs Jr DR, et al. Area characteristics and individual-level socioeconomic position indicators in three population-based epidemiologic studies. Ann Epidemiol. 2001;11(6):395–405.CrossRefPubMed
35.
Buffington CK, Marema RT. Ethnic differences in obesity and surgical weight loss between African-American and Caucasian females. Obes Surg. 2006;16(2):159–65.CrossRefPubMed
36.
Madan AK, Whitfield JD, Fain JN, et al. Are African-Americans as successful as Caucasians after laparoscopic gastric bypass? Obes Surg. 2007;17(4):460–4.CrossRefPubMed
37.
Admiraal WM, Celik F, Gerdes VE, et al. Ethnic differences in weight loss and diabetes remission after bariatric surgery: a meta-analysis. Diabetes Care. 2012;35(9):1951–8.CrossRefPubMedCentralPubMed
38.
Stevens J, Kumanyika SK, Keil JE. Attitudes toward body size and dieting: differences between elderly black and white women. Am J Public Health. 1994;84(8):1322–5.CrossRefPubMedCentralPubMed
39.
Bennett GG, McNeill LH, Wolin KY, et al. Safe to walk? neighborhood safety and physical activity among public housing residents. PLoS Med. 2007;4(10):1599–606.CrossRefPubMed
40.
Lovasi GS, Hutson MA, Guerra M, et al. Built environments and obesity in disadvantaged populations. Epidemiol Rev. 2009;31:7–20.CrossRefPubMed
41.
Delany JP, Jakicic JM, Lowery JB, et al. African American women exhibit similar adherence to intervention but lose less weight due to lower energy requirements. Int J Obes (Lond). 2013; 38(9):1147–52. doi:10.1038/ijo.2013.240.
42.
Higa K, Ho T, Tercero F, et al. Laparoscopic roux-en-Y gastric bypass: 10-year follow-up. Surg Obes Relat Dis. 2011;7(4):516–25.CrossRefPubMed
43.
Valezi AC, de Almeida Menezes M, Mali Jr J. Weight loss outcome after roux-en-Y gastric bypass: 10 years of follow-up. Obes Surg. 2013;23(8):1290–3.CrossRefPubMed
Metadata
Title
Association of Race and Socioeconomic Status with Outcomes Following Laparoscopic Roux-en-Y Gastric Bypass
Authors
Allison A. Gullick
Laura A. Graham
Joshua Richman
Manasi Kakade
Richard Stahl
Jayleen Grams
Publication date
01-04-2015
Publisher
Springer US
Published in
Obesity Surgery / Issue 4/2015
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-014-1447-z

Other articles of this Issue 4/2015

Obesity Surgery 4/2015 Go to the issue

New Concept

Laparoscopic Hand-Sewn Revisional Gastrojejunal Plication for Weight Loss Failure After Roux-en-Y Gastric Bypass

Original Contributions

Ileal Food Diversion: a Simple, Powerful and Easily Revisable and Reversible Single-Anastomosis Gastric Bypass

Other

The Web-Surfing Bariatic Patient: the Role of the Internet in the Decision-Making Process

Letter to the Editor

Heavy Feelings in the Stomach

Original Contributions

Attachment Anxiety Predicts Poor Adherence to Dietary Recommendations: an Indirect Effect on Weight Change 1 Year After Gastric Bypass Surgery

Original Contributions

Effectiveness of B Vitamin Supplementation Following Bariatric Surgery: Rapid Increases of Serum Vitamin B12