Faculty Collaboration Database

Physiologic and psychological gender differences in bariatric surgery. Surg Endosc 2018 Mar;32(3):1382-1388

Date

08/26/2017

Pubmed ID

28840338

DOI

10.1007/s00464-017-5819-z

Scopus ID

2-s2.0-85028320905 (requires institutional sign-in at Scopus site)   77 Citations

Abstract

BACKGROUND: Bariatric surgery is a safe and effective treatment for clinically severe obesity, but inequity in male and female utilization is well recognized. Approximately 20% of patients undergoing bariatric surgery are male. This paper aims to describe differences in outcomes by gender and to understand the physiologic and psychological differences that may explain this gender gap.

METHODS: We examined 61,708 patients from the Michigan Bariatric Surgery Collaborative (MBSC) undergoing primary bariatric surgery between 2006 and 2016. Clinical data regarding demographics, comorbidities, and outcomes were compared by gender. Preoperative and 1-year postoperative surveys gathered psychological outcomes.

RESULTS: This cohort was consistent with the national population with approximately 22% male patients. There were several significant differences between males and females at the time of surgery. Males tended to be older, have a higher BMI, be married, have lower self-reported depression scores, and have more comorbidities (all p < 0.05). Postoperatively, males suffered more serious complications than women (2.67 vs. 2.12, respectively, p < 0.05). At 1 year postoperatively, males were significantly more satisfied with their operation despite increased complications, decreased weight loss, and decreased rates of comorbidity resolution as compared to females (all p < 0.05).

CONCLUSIONS: Despite significantly lower weight loss and increased complication rates, males tend to have markedly higher satisfaction and psychological well-being scores than females. To improve outcomes in males, earlier referral to surgery may help to significantly reduce their risk. Conversely, increased attention to psychological support in the perioperative period for females may lead to improved psychological outcomes (i.e., body image, depression, psychological well-being).

Author List

Kochkodan J, Telem DA, Ghaferi AA

Author

Amir Ghaferi MD President, Phys Enterprise & SAD Clinical Affairs in the Medical College Physicians Administration department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Age Factors
Bariatric Surgery
Body Mass Index
Comorbidity
Depression
Female
Humans
Male
Michigan
Middle Aged
Patient Satisfaction
Postoperative Complications
Sex Factors
Weight Loss