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18-12-2023 | Obesity | Original Contributions

Factors Associated with the Decision to Complete Bariatric Metabolic Surgery among a Racially and Ethnically Diverse Sample of Adults: A Classification and Regression Tree Analysis

Authors: Luyu Xie, Folefac Atem, M. Sunil Mathew, Jaime P. Almandoz, Jeffrey N. Schellinger, Olivia Kapera, Sophia Ngenge, Jackson Francis, Elisa Morales Marroquin, Carrie McAdams, Sachin Kukreja, Benjamin E. Schneider, Sarah E. Messiah

Published in: Obesity Surgery | Issue 5/2024

Abstract

Background

Less than 50% of eligible candidates who are referred complete Bariatric Metabolic Surgery (BMS). The factors influencing the decision to complete BMS, particularly how these factors vary across different racial and ethnic groups, remain largely unexplored.

Methods

This prospective cohort study included adult patients referred to a bariatric surgeon or obesity medicine program between July 2019-September 2022. Sociodemographic characteristics, body mass index (BMI), anxiety, depression, body appreciation, and patient-physician relationship information were collected via survey and electronic health records. The association between BMS completion and potential decision-driving factors was examined using Classification and Regression Tree (CART) analysis.

Results

A total of 406 BMS -eligible patients participated in the study (mean [SD] age: 47.5 [11.6] years; 87.2% women; 18.0% Hispanic, 39% non-Hispanic Black [NHB], and 39% non-Hispanic White [NHW]; mean [SD] BMI: 45.9 [10.1] kg/m²). A total of 147 participants (36.2%) completed BMS. Overall, the most influential factor driving the decision to complete BMS was younger age (< 68.4 years), higher patient satisfaction, and BMI (≥ 38.0 kg/m²). Hispanic participants prioritized age (< 55.4 years), female sex, and body appreciation. For NHB participants, the highest ranked factors were age < 56.3 years, BMI ≥ 35.8 kg/m², and higher patient satisfaction. For NHW patients, the most influential factors were age (39.1 to 68.6 years) and higher body appreciation.

Conclusion

These findings highlight racial and ethnic group differences in the factors motivating individuals to complete BMS. By acknowledging these differences, healthcare providers can support patients from different backgrounds more effectively in their decision-making process regarding BMS.

Graphical abstract

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Title: Factors Associated with the Decision to Complete Bariatric Metabolic Surgery among a Racially and Ethnically Diverse Sample of Adults: A Classification and Regression Tree Analysis
Authors: Luyu Xie
Folefac Atem
M. Sunil Mathew
Jaime P. Almandoz
Jeffrey N. Schellinger
Olivia Kapera
Sophia Ngenge
Jackson Francis
Elisa Morales Marroquin
Carrie McAdams
Sachin Kukreja
Benjamin E. Schneider
Sarah E. Messiah
Publication date: 18-12-2023
Publisher: Springer US
Keywords: Obesity
Obesity
Psychodynamic Regression
Published in: Obesity Surgery / Issue 5/2024
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI: https://doi.org/10.1007/s11695-023-06999-0

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EASD 2024

Springer Medicine

Factors Associated with the Decision to Complete Bariatric Metabolic Surgery among a Racially and Ethnically Diverse Sample of Adults: A Classification and Regression Tree Analysis

Abstract

Background

Methods

Results

Conclusion

Graphical abstract

Mastering chronic pancreatitis pain: A multidisciplinary approach and practical solutions

EASD 2024

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Graphical abstract

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