Health Disparities in Adolescent Bariatric Surgery: Nationwide Outcomes and Utilization

Omar Nunez Lopez, Daniel C. Jupiter, Fredrick J. Bohanon, Ravi S. Radhakrishnan, Kanika A. Bowen-Jallow

Research output: Contribution to journalArticlepeer-review

28 Scopus citations

Abstract

Purpose Bariatric surgery represents an appropriate treatment for adolescent severe obesity, but its utilization remains low in this patient population. We studied the impact of race and sex on preoperative characteristics, outcomes, and utilization of adolescent bariatric surgery. Methods Retrospective analysis (2007–2014) of adolescent bariatric surgery using the Bariatric Outcomes Longitudinal Database, a national database that collects bariatric surgical care data. We assessed the relationships between baseline characteristics and outcomes (weight loss and remission of obesity-related conditions [ORCs]). Using the National Health and Nutrition Examination Survey and U.S. census data, we calculated the ratio of severe obesity and bariatric procedures among races and determined the ratio of ratios to assess for disparities. Results About 1,539 adolescents underwent bariatric surgery. Males had higher preoperative body mass index (BMI; 51.8 ± 10.5 vs. 47.1 ± 8.7, p <.001) and higher rates of obstructive sleep apnea and dyslipidemia. Blacks had higher preoperative BMI (52.4 ± 10.6 vs. 47.3 ± 8.3; 48.7 ± 8.8; 48.2 ± 12.1 kg/m2; whites, Hispanics, and others, respectively p <.001) and higher rates of hypertension, obstructive sleep apnea, and asthma. Weight loss and ORCs remission rates did not differ between sexes or races after accounting for the rate of severe obesity in each racial group. White adolescents underwent bariatric surgery at a higher proportion than blacks and Hispanics (2.5 and 2.3 times higher, respectively). Conclusions Preoperative characteristics vary according to race and sex. Race and sex do not impact 12-month weight loss or ORC's remission rates. Minority adolescents undergo bariatric surgery at lower-than-expected rates.

Original languageEnglish (US)
Pages (from-to)649-656
Number of pages8
JournalJournal of Adolescent Health
Volume61
Issue number5
DOIs
StatePublished - Nov 2017

Keywords

  • Adolescent obesity
  • Bariatric surgery
  • Gastric bypass
  • Health disparities
  • Health inequalities
  • Pediatric obesity
  • Sleeve gastrectomy

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health

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