A call to arms: Obese men with more severe comorbid disease and underutilization of bariatric operations

Gina N. Farinholt, Aaron D. Carr, Eun Jin Chang, Mohamed R Ali

Research output: Contribution to journalArticle

26 Citations (Scopus)

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/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.

Original languageEnglish (US)
Pages (from-to)4556-4563
Number of pages8
JournalSurgical Endoscopy and Other Interventional Techniques
Volume27
Issue number12
DOIs
StatePublished - Dec 2013

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Bariatrics
Comorbidity
Bariatric Surgery
Diabetes Mellitus
Obstructive Sleep Apnea
Dyslipidemias
Obesity
Hypertension
Back Pain
Musculoskeletal Diseases
Gastroesophageal Reflux
Body Mass Index

Keywords

  • Bariatric surgery
  • Diabetes
  • Hypertension
  • Male comorbidities
  • Metabolic syndrome
  • Obesity

ASJC Scopus subject areas

  • Surgery

Cite this

A call to arms : Obese men with more severe comorbid disease and underutilization of bariatric operations. / Farinholt, Gina N.; Carr, Aaron D.; Chang, Eun Jin; Ali, Mohamed R.

In: Surgical Endoscopy and Other Interventional Techniques, Vol. 27, No. 12, 12.2013, p. 4556-4563.

Research output: Contribution to journalArticle

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title = "A call to arms: Obese men with more severe comorbid disease and underutilization of bariatric operations",
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/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.",
keywords = "Bariatric surgery, Diabetes, Hypertension, Male comorbidities, Metabolic syndrome, Obesity",
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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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