TY - JOUR
T1 - Weight Loss After Bariatric Surgery
T2 - Do Clinical and Behavioral Factors Explain Racial Differences?
AU - Wee, Christina C.
AU - Jones, Daniel B.
AU - Apovian, Caroline
AU - Hess, Donald T.
AU - Chiodi, Sarah N.
AU - Bourland, Ashley C.
AU - Davis, Roger B.
AU - Schneider, Benjamin
AU - Blackburn, George L.
AU - Marcantonio, Edward R.
AU - Hamel, Mary Beth
N1 - Funding Information:
Funding The study was funded by a grant from the National Institutes of Health (R01DK073302, PI Author 1). Author 1 is also supported by a NIH Midcareer Mentorship Award (K24DK087932).
Funding Information:
The study was funded by a grant from the National Institutes of Health (R01DK073302, PI Wee). Dr. Wee is also supported by a NIH Midcareer Mentorship Award (K24DK087932). The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript. Ms. Chiodi had full access to the data and takes responsibility for the integrity and accuracy of the data. The study was funded by a grant from the National Institutes of Health (R01DK073302, PI Author 1). Author 1 is also supported by a NIH Midcareer Mentorship Award (K24DK087932). Author 3 reports grants from National Institutes of Health, from Myos, from Aspire Bariatrics, and from GI Dynamics; grants and personal fees from Amylin, from Sanofi-Aventis, from Orexigen, and from Takeda; personal fees from Merck, from Johnson & Johnson, from Arena, from Nutrisystem, from Zafgen, from EnteroMedics, and from NovoNordisk for work unrelated to the current project. Author 2 reports stock options as a consultant for Allurion. All other authors declare they have no conflict of interest.
Funding Information:
Conflict of Interest Author 3 reports grants from National Institutes of Health, from Myos, from Aspire Bariatrics, and from GI Dynamics; grants and personal fees from Amylin, from Sanofi-Aventis, from Orexigen, and from Takeda; personal fees from Merck, from Johnson & Johnson, from Arena, from Nutrisystem, from Zafgen, from EnteroMedics, and from NovoNordisk for work unrelated to the current project. Author 2 reports stock options as a consultant for Allurion. All other authors declare they have no conflict of interest.
Publisher Copyright:
© 2017, Springer Science+Business Media New York.
PY - 2017/11/1
Y1 - 2017/11/1
N2 - Background: Prior studies have suggested less weight loss among African American compared to Caucasian patients; however, few studies have been able to simultaneously account for baseline differences in other demographic, clinical, or behavioral factors. Methods: We interviewed patients at two weight loss surgery (WLS) centers and conducted chart reviews before and after WLS. We compared weight loss post-WLS by race/ethnicity and examined baseline demographic, clinical (BMI, comorbidities, quality of life), and behavioral (eating behavior, physical activity level, alcohol intake) factors that might explain observed racial differences in weight loss at 1 and 2 years after WLS. Results: Of 537 participants who underwent either Roux-en-Y Gastric Bypass (54%) or gastric banding (46%), 85% completed 1-year follow-up and 73% completed 2-year follow-up. Patients lost a mean of 33.00% of initial weight at year 1 and 32.43% at year 2 after bypass and 16.07% and 17.56 % respectively after banding. After adjustment for other demographic characteristics and type of surgery, African Americans lost an absolute 5.93 ± 1.49% less weight than Caucasian patients after bypass (p < 0.001) and 4.72 ± 1.96% less weight after banding. Of the other demographic, clinical, behavioral factors considered, having diabetes and perceived difficulty making dietary changes at baseline were associated with less weight loss among gastric bypass patients whereas having a diagnosis of anxiety disorder was associated with less weight loss among gastric banding patients. The association between race and weight loss did not substantially attenuate with additional adjustment for these clinical and behavioral factors, however. Conclusion: African American patients lost significantly less weight than Caucasian patients. Racial differences could not be explained by baseline demographic, clinical, or behavioral characteristics we examined.
AB - Background: Prior studies have suggested less weight loss among African American compared to Caucasian patients; however, few studies have been able to simultaneously account for baseline differences in other demographic, clinical, or behavioral factors. Methods: We interviewed patients at two weight loss surgery (WLS) centers and conducted chart reviews before and after WLS. We compared weight loss post-WLS by race/ethnicity and examined baseline demographic, clinical (BMI, comorbidities, quality of life), and behavioral (eating behavior, physical activity level, alcohol intake) factors that might explain observed racial differences in weight loss at 1 and 2 years after WLS. Results: Of 537 participants who underwent either Roux-en-Y Gastric Bypass (54%) or gastric banding (46%), 85% completed 1-year follow-up and 73% completed 2-year follow-up. Patients lost a mean of 33.00% of initial weight at year 1 and 32.43% at year 2 after bypass and 16.07% and 17.56 % respectively after banding. After adjustment for other demographic characteristics and type of surgery, African Americans lost an absolute 5.93 ± 1.49% less weight than Caucasian patients after bypass (p < 0.001) and 4.72 ± 1.96% less weight after banding. Of the other demographic, clinical, behavioral factors considered, having diabetes and perceived difficulty making dietary changes at baseline were associated with less weight loss among gastric bypass patients whereas having a diagnosis of anxiety disorder was associated with less weight loss among gastric banding patients. The association between race and weight loss did not substantially attenuate with additional adjustment for these clinical and behavioral factors, however. Conclusion: African American patients lost significantly less weight than Caucasian patients. Racial differences could not be explained by baseline demographic, clinical, or behavioral characteristics we examined.
KW - Bariatric surgery
KW - Gastric banding
KW - Race
KW - Roux-Y gastric bypass
KW - Weight loss
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UR - http://www.scopus.com/inward/citedby.url?scp=85019189212&partnerID=8YFLogxK
U2 - 10.1007/s11695-017-2701-y
DO - 10.1007/s11695-017-2701-y
M3 - Article
C2 - 28500418
AN - SCOPUS:85019189212
SN - 0960-8923
VL - 27
SP - 2873
EP - 2884
JO - Obesity Surgery
JF - Obesity Surgery
IS - 11
ER -