Bariatric surgery barriers: a review using Andersen’s Model of Health Services Use

Imbus, Joseph R.; Voils, Corrine I.; Funk, Luke M.

doi:10.1016/j.soard.2017.11.012

Cited by 78 publications

(57 citation statements)

References 43 publications

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“…Access to obesity surgery is no different in many countries, including Brazil. Financing problems, a limited number of specialized surgical centers and complex requirements for the creation of new centers [27] are some of the reasons for the restricted access to publicly funded obesity surgery. The waiting time for surgery is usually long and lists of patients are formed on a first-come, first-served basis.…”

Section: Discussionmentioning

confidence: 99%

The Edmonton Obesity Staging System: assessing a potential tool to improve the management of obesity surgery in the Brazilian public health services

Ogassavara

Dias

Pajecki

et al. 2020

Surgery for Obesity and Related Diseases

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Section: Discussionmentioning

confidence: 99%

The Edmonton Obesity Staging System: assessing a potential tool to improve the management of obesity surgery in the Brazilian public health services

Ogassavara

Dias

Pajecki

et al. 2020

Surgery for Obesity and Related Diseases

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“…Metabolic and bariatric surgery has been proven to be the most effective treatment for class II and III obesity and yet remains highly underutilized [9][10][11][12][13]. Primary bariatric procedures performed in the USA include laparoscopic Roux-en-Y gastric bypass (RYGB) and laparoscopic sleeve gastrectomy (SG) [9,11,[14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Bariatric Surgery Outcomes in Appalachia Influenced by Surgery Type, Diabetes, and Depression

et al. 2019

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Background Most effective treatment for morbid obesity and its comorbidities is bariatric surgery. However, research is limited on weight loss and associated outcomes among patients in Appalachia. The objective of this study was to examine demographic and comorbidity influence on surgical outcomes of this population including age, sex, race, state of residence, education, marital status, body mass index (BMI kg/m 2), excess body weight (EBW), percent excess weight loss (%EWL), blood pressure, diagnosed depression, diagnosed type 2 diabetes (T2D), Beck Depression Inventory-II (BDI-II), and laboratory values (i.e., hemoglobin A1c). Methods A retrospective electronic medical record (EMR) data extraction was performed on N = 582 patients receiving bariatric surgery (laparoscopic Roux-en-Y gastric bypass [RYGB] and laparoscopic sleeve gastrectomy [SG]) between 10/2013 and 2/2017. Results Patient population was 92.5% Caucasian, 79.3% female, 62.8% married, 45 ± 11.1 years, 75.8% received RYGB, and 24.2% received SG. Average %EWL from baseline to 1-year follow-up was 68.5 ± 18.4% (n = 224). In final descriptive models, surgery type, diagnosed T2D, HbA1c, and depressive symptoms were significant covariates associated with lower %EWL. Conclusions Findings suggest patients completing surgery within an Appalachian region have successful surgical outcomes at 1year post-surgery, as indicated by significant reductions of > 50% EWL, regardless of other covariates. Results suggest that bariatric programs should consider paying special consideration to patients with T2D or depressive symptoms to improve outcomes. Results have potential to inform future prospective studies and aid in guiding specific interventions tailored to address needs of this unique population.

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“…When analyzing literature regarding health disparities in the Appalachian region, many previously mentioned factors among the population can be antagonistic toward weight loss such as environmental influences, health literacy, access to resources, and co-morbid conditions. [113]. In Figure 3, rates of diabetes, obesity, and surgeries performed in 2012 per 100,000 population are depicted [114].…”

Section: Bariatric Surgery As An Interventionmentioning

confidence: 99%

“…A target population needing to follow a specific dietary regimen are post-bariatric surgery patients residing in these food-desert areas. As bariatric surgery is the most effective treatment for morbid obesity (Body Mass Index of >40kg/m 2 or >35kg/m 2 with comorbidities) [3,90,113,154,155], those receiving the surgery in the top ranking state of obesity, West Virginia, are underrepresented within the literature [27]. Lifestyle adjustments after bariatric surgery should change to following a lifelong, healthful, nutritious diet.…”

Section: Introductionmentioning

confidence: 99%

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Appalachian Bariatric Surgery Population Descriptive Analysis, Surgical Outcomes, and Food Accessibility

Barr¹

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Describing an Appalachian bariatric patient population through surgical outcomes and food access Makenzie L. Barr Introduction. Overweight and obesity, diabetes, mental health issues, and lack of access to healthcare resources are frequent burdens among the Appalachian region of the United States. With morbid obesity, conventional behavioral interventions tend to fail. Bariatric surgery has been deemed the most successful treatment for morbid obesity and is performed regularly worldwide, however, the Appalachian population with the highest proportions of obesity and related co-morbidities has been poorly studied. Aims. This dissertation aims to (1) provide a systematic review of the literature surrounding obesity and food access among Appalachian residents, (2) address the void in research of characterizing Appalachian bariatric surgery patients through descriptive statistics of demographic, co-morbidities, psychological scores, nutritional habits, baseline physical measures, and surgical outcomes, and (3) determine Food Access Ranking Scores of an Appalachian bariatric surgery population through Geographical Information Systems (GIS) locating patient addresses and its relationship to descriptive variables. Methods. A retrospective chart review was performed on bariatric surgery patients who had been enrolled in a bariatric surgery program and completed gastric bypass or sleeve gastrectomy surgery between March 2013 and April 2017. Twenty-four research assistants were trained to retrieve data from over 540 bariatric patients Electronic Medical Record. Data collected from initial visit clinic questionnaires included demographics, socioeconomic status, past and current health status, family history, baseline dietary behaviors and anthropometrics. Repeated anthropometric data was recorded from patients attending one-year follow-up visits. Additional mapping of patient geographical location was conducted to identify rural locality of the population. Results. In a systematic review, minimal research was found regarding obesity and food access within the Appalachian region were found. Within the limited findings, although conflicting, most work suggests increasing obesity is correlated with low food access. Our bariatric population was largely defined in the categories of low and moderate-low food access. Access food scores were significantly related to depression and ethnicity. Specifically, bariatric patients with lower food access scores were diagnosed with depression and were mostly non-Caucasian. Lower values of excess weight loss at one-year followup were found in patients receiving sleeve surgery type, diagnosed with diabetes, depression, or having a higher Hemoglobin A1c percentage at baseline compared to those receiving bypass surgery and without co-morbidities. Conclusion. Minimal research has been explored among bariatric surgery patients who live in an area with the largest rates of obesity, co-morbidities and rural locality. This work aimed to fill the void in describing the Appalachian bariatric surgery p...

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Bariatric surgery barriers: a review using Andersen’s Model of Health Services Use

Cited by 78 publications

References 43 publications

The Edmonton Obesity Staging System: assessing a potential tool to improve the management of obesity surgery in the Brazilian public health services

The Edmonton Obesity Staging System: assessing a potential tool to improve the management of obesity surgery in the Brazilian public health services

Bariatric Surgery Outcomes in Appalachia Influenced by Surgery Type, Diabetes, and Depression

Appalachian Bariatric Surgery Population Descriptive Analysis, Surgical Outcomes, and Food Accessibility

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