A Call to Arms: Obese Men with More Severe Comorbid Disease and Underutilization of Bariatric Operations

Overview

Journal Surg Endosc

Publisher Springer

Specialties Gastroenterology
General Surgery
Radiology

Date 2013 Aug 17

PMID 23949482

Citations 24

Authors

Gina N Farinholt

Aaron D Carr

Eun Jin Chang

Mohamed R Ali

Affiliations

Soon will be listed here.

Abstract

Background: Despite similar rates of obesity among American men and women, population-based studies suggest that bariatric surgery patients are disproportionately female. We sought to assess this observation quantitatively.

Methods: Data were prospectively collected from 1,368 consecutive patients evaluated for bariatric surgery over a 4-year period. The prevalence of diabetes mellitus (DM), hypertension (HTN), dyslipidemia (DYS), obstructive sleep apnea (OSA), gastroesophageal reflux disease, depression, back pain (BKP), and musculoskeletal peripheral disease was assessed. A severity score from 1 to 5 had been assigned to each comorbidity based on the Assessment of Obesity Related Comorbidities Scale (AORC). Metabolic syndrome (MetS) was defined as the concurrent presence of DM, HTN, and DYS.

Results: The majority of patients were female (n = 1,115, 81.5%). Male patients were older (44.5 ± 9.5 vs. 42.6 ± 9.6 years, p = 0.0044) and had higher body mass index (48.7 ± 7.8 vs. 46.6 ± 7.4 kg/m(2), p < 0.0001). On average, men presented with 4.54 serious comorbidities and 3.7 complicated comorbidities (AORC score ≥3), whereas women presented with 4.15 serious comorbidities and 3.08 complicated comorbidities. More men presented with DM (36.4 vs. 28.9%, p = 0.0154), HTN (68.8 vs. 55.3%, p = 0.0001), OSA (71.9 vs. 45.7%, p < 0.0001), and MetS (20.9 vs. 15.2%, p = 0.0301). Men also presented with more complicated DM (33.2 vs. 23.9%, p = 0.0031), DYS (36.8 vs. 23.5%, p < 0.0001), HTN (58.9 vs. 44.6%, p < 0.0001), BKP (25.3 vs. 19.3%, p = 0.0378), OSA (56.9 vs. 30.1%, p < 0.0001), and MetS (17.8 vs. 10.0%, p = 0.001).

Conclusions: Although men typically comprise less than 20% of bariatric surgery patients, they potentially have more to gain from these operations. Men present later in life, with more advanced obesity, and with more complicated comorbidities. Such findings mandate more research and resources to investigate this barrier to treatment and to provide the morbidly obese male with the surgical care he clearly needs.

Citing Articles

Association of Sex Differences on Weight Loss and Complications Following Bariatric Surgery.

Hider A, Bonham A, Carlin A, Finks J, Ghaferi A, Varban O J Surg Res. 2024; 299:359-365.

PMID: 38795559 PMC: 11475018. DOI: 10.1016/j.jss.2024.04.050.

Prediabetes remission after bariatric surgery: a 4-years follow-up study.

Borges-Canha M, Neves J, Silva M, Mendonca F, Moreno T, Ribeiro S BMC Endocr Disord. 2024; 24(1):7.

PMID: 38200480 PMC: 10782579. DOI: 10.1186/s12902-024-01537-0.

Procedure Matters in Gender-Associated Outcomes following Metabolic-Bariatric Surgery: Five Year North American Matched Cohort Analysis.

Bharani T, Sheu E, Robinson M Obes Surg. 2023; 33(10):3090-3096.

PMID: 37453989 DOI: 10.1007/s11695-023-06722-z.

Bariatric Surgery: Late Outcomes in Patients Who Reduced Comorbidities at Early Follow-Up.

Almeida R, Aidar F, de Souza M, Oliveira V, Oliveira J, Baumworcel L Medicina (Kaunas). 2021; 57(9).

PMID: 34577918 PMC: 8472676. DOI: 10.3390/medicina57090995.

Sex disparity in laparoscopic bariatric surgery outcomes: a matched-pair cohort analysis.

Mousapour P, Tasdighi E, Khalaj A, Mahdavi M, Valizadeh M, Taheri H Sci Rep. 2021; 11(1):12809.

PMID: 34140595 PMC: 8211818. DOI: 10.1038/s41598-021-92254-4.

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