Darren D Moore1, David E Arterburn2, Yun Bai3, Melissa Cornejo4, Cecelia L Crawford5, Adam Drewnowski6, Marlaine Figueroa Gray2, Ming Ji3, Kristina H Lewis7, Silvia Paz4, Brianna Taylor4, Tae K Yoon4, Deborah Rohm Young4, Karen J Coleman8. 1. Marriage and Family Therapy Program, Touro University Worldwide, Los Alamitos, CA, USA. 2. Health Research Institute, Kaiser Permanente Washington, Seattle, WA, USA. 3. College of Nursing, University of South Florida, Tampa, FL, USA. 4. Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA. 5. Regional Nursing Research Program, Kaiser Permanente Southern California, Pasadena, CA, USA. 6. Center for Public Health Nutrition, University of Washington, Seattle, WA, USA. 7. SM Division of Public Health Sciences, Department of Epidemiology & Prevention, Wake Forest University Health Sciences, Winston-Salem, NC, USA. 8. Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA. Karen.J.Coleman@kp.org.
Abstract
PURPOSE: Bariatric surgery is the most effective treatment for severe obesity, but currently, only 1-2% of all eligible patients undergo surgery each year. This study examined which factors were associated with a patient receiving bariatric surgery after referral in a real-world healthcare setting. MATERIALS AND METHODS: The current study used the baseline survey and electronic medical record (EMR) data from the Bariatric Experience Long Term (BELONG) study (n = 1975). Predictors of who did (n = 1680) and who did not (n = 295) have surgery were analyzed using multivariate logistic regression. RESULTS: Participants (n = 1975; 42.4% response rate) were primarily women (84%) and either non-Hispanic Black or Hispanic (60%). In the fully adjusted multivariate model, the strongest predictors of having surgery were being a woman (OR = 3.17; 95% CI = 2.15, 4.68; p < .001) and losing at least 5% of their body weight in the year before surgery (OR = 3.16; 95% CI = 2.28, 4.38; p < .001). The strongest predictors of not having surgery were a ≥ BMI 50 kg/m2 (OR = .39; 95% CI = .27, .56; p < .001) and having a higher physical comorbidity burden (OR = .84; 95% CI = .75, .94; p = .004). CONCLUSIONS: Practices such as 5-10% total weight loss before surgery and selection of patients with safer operative risk profiles (younger with lower comorbidity burden) may inadvertently contribute to under-utilization of bariatric surgery among some demographic subpopulations who could most benefit from this intervention.
PURPOSE: Bariatric surgery is the most effective treatment for severe obesity, but currently, only 1-2% of all eligible patients undergo surgery each year. This study examined which factors were associated with a patient receiving bariatric surgery after referral in a real-world healthcare setting. MATERIALS AND METHODS: The current study used the baseline survey and electronic medical record (EMR) data from the Bariatric Experience Long Term (BELONG) study (n = 1975). Predictors of who did (n = 1680) and who did not (n = 295) have surgery were analyzed using multivariate logistic regression. RESULTS: Participants (n = 1975; 42.4% response rate) were primarily women (84%) and either non-Hispanic Black or Hispanic (60%). In the fully adjusted multivariate model, the strongest predictors of having surgery were being a woman (OR = 3.17; 95% CI = 2.15, 4.68; p < .001) and losing at least 5% of their body weight in the year before surgery (OR = 3.16; 95% CI = 2.28, 4.38; p < .001). The strongest predictors of not having surgery were a ≥ BMI 50 kg/m2 (OR = .39; 95% CI = .27, .56; p < .001) and having a higher physical comorbidity burden (OR = .84; 95% CI = .75, .94; p = .004). CONCLUSIONS: Practices such as 5-10% total weight loss before surgery and selection of patients with safer operative risk profiles (younger with lower comorbidity burden) may inadvertently contribute to under-utilization of bariatric surgery among some demographic subpopulations who could most benefit from this intervention.
Entities:
Keywords:
Gender differences; Health disparities; Surgical decision-making
Authors: Anita Courcoulas; R Yates Coley; Jeanne M Clark; Corrigan L McBride; Elizabeth Cirelli; Kathleen McTigue; David Arterburn; Karen J Coleman; Robert Wellman; Jane Anau; Sengwee Toh; Cheri D Janning; Andrea J Cook; Neely Williams; Jessica L Sturtevant; Casie Horgan; Ali Tavakkoli Journal: JAMA Surg Date: 2020-03-01 Impact factor: 14.766
Authors: Karen J Coleman; Silvia R Paz; Bhumi B Bhakta; Brianna Taylor; Jialuo Liu; Tae K Yoon; Mayra Macias; David E Arterburn; Cecelia L Crawford; Adam Drewnowksi; Marlaine S Figueroa Gray; Laurel D Hansell; Ming Ji; Kristina H Lewis; Darren D Moore; Sameer B Murali; Deborah R Young Journal: BMJ Open Date: 2022-05-24 Impact factor: 3.006
Authors: Kristina H Lewis; Ming Ji; Yun Bai; David E Arterburn; Bhumi B Bhakta; Melissa Cornejo; Cecelia L Crawford; Adam Drewnowski; Marlaine Figueroa Gray; Darren D Moore; Sameer B Murali; Silvia R Paz; Brianna Taylor; Tae K Yoon; Deborah Rohm Young; Karen J Coleman Journal: Appetite Date: 2021-02-04 Impact factor: 5.016