The Impact of Ethnicity on Metabolic Outcomes After Bariatric Surgery

Valencia, Arelí; Garcia, Luis; Morton, John M.

doi:10.1016/j.jss.2018.09.061

Cited by 11 publications

(5 citation statements)

References 16 publications

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“…NHWs were more likely to have a greater percentage of excess weight loss than NHBs in a systematic review of outcomes after bariatric surgery [78], but this is not explained by demographic, clinical, or behavioral factors [79]. In a multi-ethnic study of diabetic subjects undergoing bariatric surgery, NHBs and Asians were less likely to have a durable decrease in their metabolic profile with time, and Asians were less likely to continue to lose weight after 6 months compared with NHWs and Hispanics [80].…”

Section: Therapeutic Interventions For Obesity and Nafldmentioning

confidence: 96%

Ethnic Disparities in Adiposity: Focus on Non-alcoholic Fatty Liver Disease, Visceral, and Generalized Obesity

et al. 2019

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Purpose of Review Excessive adiposity has become a public health problem worldwide, contributing to the rise in obesity-related diseases and associated morbidity and mortality. This review details the relative significance of race/ethnicity as it pertains to adiposity and non-alcoholic fatty liver disease (NAFLD). Recent Findings Fat distribution remains a more reliable measure of adiposity than anthropometric measures, with visceral adipose tissue (VAT) associated with increased risk of cardiometabolic disease. While obesity is the most common risk factor for NAFLD, the racial/ethnic prevalence of obesity does not completely parallel NAFLD risk. Summary Combating racial/ethnic disparities in obesity requires understanding differential risk among various groups. Hispanics are disproportionally impacted by NAFLD and have high rates of obesity, VAT, and insulin resistance (IR). This contrasts with Blacks, who have high prevalence of obesity and IR, accompanied by a paradoxically favorable lipid profile and low prevalence of VAT and NAFLD. Many features of adiposity and NAFLD are mediated by genetic and environmental factors, the latter being modifiable and the focus of interventions.

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Section: Therapeutic Interventions For Obesity and Nafldmentioning

confidence: 96%

Ethnic Disparities in Adiposity: Focus on Non-alcoholic Fatty Liver Disease, Visceral, and Generalized Obesity

et al. 2019

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“…Patients of minority backgrounds and low socioeconomic status undergo bariatric surgery at higher rates than before; however, these patients often demonstrate worse outcomes than their white counterparts. This has been consistently demonstrated in black patients, yet the effect on Hispanic patients has been less clear [19,[42][43][44]. While some studies show less weight loss in Hispanic patients when compared to white patients after bariatric surgery, others show similar weight and comorbidity improvement between the two groups [42][43][44].…”

Section: Discussionmentioning

confidence: 97%

“…This has been consistently demonstrated in black patients, yet the effect on Hispanic patients has been less clear [19,[42][43][44]. While some studies show less weight loss in Hispanic patients when compared to white patients after bariatric surgery, others show similar weight and comorbidity improvement between the two groups [42][43][44]. When specifically evaluating blood lipid profiles, Istfan et al found that although all races had significant improvements in blood lipids 2 years after Roux-en-Y gastric bypass, Hispanics had an increase in total cholesterol and low-density lipoprotein when compared to white and black patients [24].…”

Section: Discussionmentioning

confidence: 98%

Introducing a Bariatric Surgery Program at a Large Urban Safety Net Medical Center Serving a Primarily Hispanic Patient Population

et al. 2021

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Background Few bariatric surgery programs exist at safety net hospitals which often serve patients of diverse racial and socioeconomic backgrounds. A bariatric surgery program was developed at a large urban safety net medical center serving a primarily Hispanic population. The purpose of this study was to evaluate safety, feasibility, and first-year outcomes to pave the way for other safety net bariatric programs. Methods The bariatric surgery program was started at a safety net hospital located in a neighborhood with over twice the national poverty rate. A retrospective review was performed for patient demographics, comorbidities, preoperative diet and exercise habits, perioperative outcomes, and 1-year outcomes including percent total weight lost (%TWL) and comorbidity reduction. Results A total of 153 patients underwent laparoscopic sleeve gastrectomy from May 2017 through December 2019. The average preoperative BMI was 47.9kg/m 2 , and 54% of patients had diabetes. The 1-year follow-up rate was 94%. There were no mortalities and low complication rates. The average 1-year %TWL was 22.8%. Hypertension and diabetes medications decreased in 52% and 55% of patients, respectively. The proportion of diabetic patients with postoperative HbA1c <6.0% was 49%. Conclusion This is one of the first reports on the outcomes of a bariatric surgery program at a safety net hospital. This analysis demonstrates feasibility and safety, with no mortalities, low complication rates, and acceptable %TWL and comorbidity improvement. More work is needed to investigate the impacts of race, culture, and socioeconomic factors on bariatric outcomes in this population.

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“…B 378: 20220215 behavioural interventions, anti-obesity medications and bariatric surgery. In the US, White patients lose more weight than Black, Hispanic, American Indian and Alaskan Native patients for all treatments, owing largely to variations in economic, political and sociocultural determinants of health, rather than genetics [75][76][77][78][79][80][81][82][83]. Environmental-level factors directly and indirectly impact dietary and physical activity behaviours, acting below conscious awareness [80].…”

Section: Optimizing Treatment Effectiveness and Public Health Measure...mentioning

confidence: 99%

Breaking down silos: the multifaceted nature of obesity and the future of weight management

Newsome

Darcey

Deemer

et al. 2023

Phil. Trans. R. Soc. B

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The continued global increase in the prevalence of obesity prompted a meeting at the Royal Society of London investigating causal mechanisms of the disease, ‘Causes of obesity: theories, conjectures, and evidence’ in October 2022. Evidence presented indicates areas of obesity science where there have been advancements, including an increased understanding of biological and physiological processes of weight gain and maintenance, yet it is clear there is still debate on the relative contribution of plausible causes of the modern obesity epidemic. Consensus was reached that obesity is not a reflection of diminished willpower, but rather the confluence of multiple, complex factors. As such, addressing obesity requires multifactorial prevention and treatment strategies. The accumulated evidence suggests that a continued focus primarily on individual-level contributors will be suboptimal in promoting weight management at the population level. Here, we consider individual biological and physiological processes within the broader context of sociodemographic and sociocultural exposures as well as environmental changes to optimize research priorities and public health efforts. This requires a consideration of a systems-level approach that efficiently addresses both systemic and group-specific environmental determinants, including psychosocial factors, that often serve as a barrier to otherwise efficacious prevention and treatment options. This article is part of a discussion meeting issue ‘Causes of obesity: theories, conjectures and evidence (Part I)’.

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The Impact of Ethnicity on Metabolic Outcomes After Bariatric Surgery

Cited by 11 publications

References 16 publications

Ethnic Disparities in Adiposity: Focus on Non-alcoholic Fatty Liver Disease, Visceral, and Generalized Obesity

Ethnic Disparities in Adiposity: Focus on Non-alcoholic Fatty Liver Disease, Visceral, and Generalized Obesity

Introducing a Bariatric Surgery Program at a Large Urban Safety Net Medical Center Serving a Primarily Hispanic Patient Population

Breaking down silos: the multifaceted nature of obesity and the future of weight management

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