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 language | English (US) |
|---|---|
| Journal | Journal of Adolescent Health |
| DOIs | |
| State | Accepted/In press - 2017 |
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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
Cite this
Health Disparities in Adolescent Bariatric Surgery : Nationwide Outcomes and Utilization. / Nunez Lopez, Omar; Jupiter, Daniel; Bohanon, Fredrick J.; Radhakrishnan, Ravi; Bowen-Jallow, Kanika.
In: Journal of Adolescent Health, 2017.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Health Disparities in Adolescent Bariatric Surgery
T2 - Nationwide Outcomes and Utilization
AU - Nunez Lopez, Omar
AU - Jupiter, Daniel
AU - Bohanon, Fredrick J.
AU - Radhakrishnan, Ravi
AU - Bowen-Jallow, Kanika
PY - 2017
Y1 - 2017
N2 - 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.
AB - 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.
KW - Adolescent obesity
KW - Bariatric surgery
KW - Gastric bypass
KW - Health disparities
KW - Health inequalities
KW - Pediatric obesity
KW - Sleeve gastrectomy
UR - http://www.scopus.com/inward/record.url?scp=85028530576&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85028530576&partnerID=8YFLogxK
U2 - 10.1016/j.jadohealth.2017.05.028
DO - 10.1016/j.jadohealth.2017.05.028
M3 - Article
C2 - 28867350
AN - SCOPUS:85028530576
JO - Journal of Adolescent Health
JF - Journal of Adolescent Health
SN - 1054-139X
ER -