TY - JOUR
T1 - A call to arms
T2 - Obese men with more severe comorbid disease and underutilization of bariatric operations
AU - Farinholt, Gina N.
AU - Carr, Aaron D.
AU - Chang, Eun Jin
AU - Ali, Mohamed R
PY - 2013/12
Y1 - 2013/12
N2 - 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/m2, 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.
AB - 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/m2, 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.
KW - Bariatric surgery
KW - Diabetes
KW - Hypertension
KW - Male comorbidities
KW - Metabolic syndrome
KW - Obesity
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U2 - 10.1007/s00464-013-3122-1
DO - 10.1007/s00464-013-3122-1
M3 - Article
C2 - 23949482
AN - SCOPUS:84890115692
VL - 27
SP - 4556
EP - 4563
JO - Surgical Endoscopy and Other Interventional Techniques
JF - Surgical Endoscopy and Other Interventional Techniques
SN - 0930-2794
IS - 12
ER -