Neighborhood deprivation and residential property values do not affect weight loss at 1 or 3 years after bariatric surgery

Abstract

Objective This study examined the association between individual‐ and neighborhood‐level sociodemographic factors and surgical weight loss at 1 year (short term) and 3 years (long term). Methods Data were obtained from the baseline survey of the BELONG (Bariatric Experience Long Term) prospective longitudinal cohort study. Individual‐level self‐reported data on sex, race and ethnicity, education, and household income were obtained by survey. Data from the 2010 US Census were used to calculate area Neighborhood Deprivation Index score and median value of owner‐occupied housing units at the census tract level. Results Patients (N = 1341) had a mean age of 43.4 (SD 11.3) years, were mostly female (86%), were mostly Black or Hispanic (52%), had some college education (83%), and had annual household incomes ≥$51,000 (55%). Percentage total weight loss was 25.8% (SD 9.0%) at year 1 and 22.2% (SD 10.5%) at year 3. Race and ethnicity and age were significant predictors of weight loss at 1 and 3 years with a small effect of self‐reported household income at year 1. There were no significant associations between census tract–level Neighborhood Deprivation Index score or value of owner‐occupied housing units and weight loss at either time point. Conclusions Health systems could improve the chances of weight‐loss maintenance after surgery by addressing factors related to racial and ethnic disparities and to income disparities.

Long term cost outcomes among commercially insured patients undergoing bariatric surgical procedures

“…association between census tract-level Neighborhood Deprivation Index score and weight loss at either time point. 28 This study's findings of similar outcomes by SES may be due to the advances in the procedures and the robustness of the sample. This is an important finding…”

“…Prior studies focused on the association between weight loss and SES status and the results have been mixed. 16,20,27,28 One of the studies examined the association between individual-and neighborhood-level sociodemographic factors and surgical weight loss at 1 and 3 years and found no significant F I G U R E 3 Adjusted cost ratios of the surgical group versus non-surgical group by follow-up year and cost category. Total medical cost includes sum of inpatient, emergency, and outpatient costs.…”

“…To the authors' knowledge, this is the first study using commercial insurance data to examine the follow‐up cost post‐surgery by members' SES. Prior studies focused on the association between weight loss and SES status and the results have been mixed 16,20,27,28 . One of the studies examined the association between individual‐ and neighborhood‐level sociodemographic factors and surgical weight loss at 1 and 3 years and found no significant association between census tract‐level Neighborhood Deprivation Index score and weight loss at either time point 28 .…”

“…Prior studies focused on the association between weight loss and SES status and the results have been mixed. 16 , 20 , 27 , 28 One of the studies examined the association between individual‐ and neighborhood‐level sociodemographic factors and surgical weight loss at 1 and 3 years and found no significant association between census tract‐level Neighborhood Deprivation Index score and weight loss at either time point. 28 This study's findings of similar outcomes by SES may be due to the advances in the procedures and the robustness of the sample.…”

Game changers: do new medications make lifestyle‐based treatment of obesity obsolete?

“…Tirzepatide, semaglutide, and even older, non‐glucagon‐like peptide‐1 receptor agonist (GLP‐1RA) AOMs impact physiologic pathways and symptoms that otherwise make it difficult to initiate and sustain clinically significant weight loss. Additionally, although AOMs, like behavioral interventions, cannot change a patient's external environment, they may be able change one's response to that environment, resulting in durable weight loss despite the persistence of external challenges, much like bariatric surgery [10]. Given that the future of obesity treatment is likely to prominently feature AOMs, many are left wondering: what is the role for lifestyle and behavioral treatments moving forward?…”