Clinical Science
Bariatric surgery outcomes in black patients with super morbid obesity: a 1-year postoperative review

https://doi.org/10.1016/j.amjsurg.2016.05.010Get rights and content

Abstract

Background

Super morbid obesity (body mass index [BMI] > 50 kg/m2) is associated with significant comorbidities and is disparagingly prevalent among the black population. There is paucity of data regarding bariatric surgery outcomes among super morbid obese (SMO) blacks. Our aim is to evaluate the reduction in weight and resolution of comorbidities after bariatric surgery among SMO black patients at an urban academic institution.

Methods

A retrospective review of SMO black patients who underwent bariatric surgery from August 2008 to June 2013 at Howard University Hospital. Outcomes of interest include weight loss, improvement or resolution of hypertension, type 2 diabetes, and hyperlipidemia at 12 months.

Results

Eighty-seven patients met our inclusion criteria. Mean preoperative weight and BMI were 347.2 lbs and 56.8 kg/m2, respectively. At 12 months, mean weight and BMI were 245.3 lbs and 40.1 kg/m2, respectively. There was also significant improvement or resolution of hypertension, type 2 diabetes, and hyperlipidemia.

Conclusions

Bariatric surgery may result in significant weight loss and improvement or resolution of comorbidities in SMO black patients.

Section snippets

Methods

We conducted a retrospective review of prospectively collected data of patients undergoing weight loss surgery from August 2008 to June 2013 at the Howard University Center for Wellness and Weight Loss Surgery in Washington, DC. Howard University Center for Wellness and Weight Loss Surgery is an accredited Center of Excellence by the American College of Surgeons Bariatric Surgery Center Network. Using the National Institutes of Health criteria17 for patient selection, all patients underwent

Results

We reviewed a total number of 284 patients; 87 of which met our inclusion criteria. Of the 87 patients, the majority was female (87%). The mean age at time of surgery was 42 ± 10.3 years. The mean preoperative weight was 347.2 ± 56.3 lbs, and mean preoperative BMI was 56.7 ± 6.4 kg/m2. The most common comorbid condition was hypertension (74%), followed by diabetes mellitus (32%), and hyperlipidemia (26%). Eighty percent of our patients underwent LRYGB, while 20% underwent LSG. As a group,

Univariate

Our study focused exclusively on 87 black patients with a BMI ≥ 50 kg/m2. The majority of our patients were female with an average age of 42 years. While studies by Lutfi et al19 and Melton et al20 were able to conclude that the higher the BMI of a patient is above 50, the less weight they will lose when compared to patients with a BMI of less than 50 kg/m2, our patients showed a marked decrease in BMI. Our overall patient population had a change in weight of a 100 lbs and BMI of 16.7 kg/m2 in

Conclusions

Black patients with SMO had a significant decrease in BMI, excess weight loss, and resolution of comorbidities at 12 months after bariatric surgery. This suggests bariatric surgery may be a viable modality in the treatment of SMO black patients. Longer follow-up will be necessary to elucidate quality of life metrics and sustainable weight loss.

References (39)

  • P.E. O'Brien

    Bariatric surgery: mechanisms, indications and outcomes

    J Gastroenterol Hepatol

    (2010)
  • R. Sturm et al.

    Morbid obesity rates continue to rise rapidly in the United States

    Int J Obes (Lond)

    (2013)
  • S.F. Noria et al.

    Biological effects of bariatric surgery on obesity-related comorbidities

    Can J Surg

    (2013)
  • Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. Available at:...
  • Management of Overweight and Obesity. Available at: http://www.oqp.med.va.gov/cpg/OBE/OBE_base.htm. Accessed November...
  • P.R. Schauer et al.

    Outcomes after laparoscopic Roux en y gastric bypass for morbid obesity

    Ann Surg

    (2000)
  • D.R. Flum et al.

    Perioperative safety in the longitudinal assessment of bariatric surgery

    N Engl J Med

    (2009)
  • L. Residori et al.

    Prevalence of co-morbidities in obese patients before bariatric surgery: effect of race

    Obes Surg

    (2003)
  • T.Y. Warren et al.

    Independent association of waist circumference with hypertension and diabetes in African American women, South Carolina, 2007-2009

    Prev Chronic Dis

    (2012)

    • Cited by (6)

    There were no relevant financial relationships or any sources of support in the form of grants, equipment, or drugs.

    The authors declare no conflicts of interest.

    View full text
    © 2016 Published by Elsevier Inc.