Researchers analyze racial disparities in access to bariatric surgery

Reviewed by Emily Henderson, B.Sc.October 29, 2020

The use of bariatric surgery for the treatment of severe obesity in adolescents and racial disparities in access to such treatment were analyzed in a retrospective study published in Annals of surgery by researchers at the University of Texas Health Science Center at Houston (UTHealth).

Nearly 19% of children and adolescents in the United States are obese. As many obese children become obese adults, childhood obesity can be linked to mortality and morbidity in adulthood, making it a leading cause of death in the United States. Ethnic minority groups have the highest rates of severe obesity in the country.

Unsurprisingly, childhood obesity has been a challenge in this country for decades from both a public health and a clinical perspective. Most alarming is that over the past 5-10 years we have seen an increase in those suffering from severe obesity. This patient group is growing three times faster than obese adolescents. “

Sarah Messiah, PhD, MPH, lead author of the study and professor, epidemiology, human genetics, and environmental science, University of Texas Health Science Center in Houston

Pediatricians often suggest lifestyle modifications such as dietary changes to reduce calorie intake and increase physical activity. However, dietary and behavioral changes alone have not been shown to be successful in treating children and adolescents with severe obesity.

Messiah and other researchers suggested in the paper that bariatric surgery, commonly known as weight loss surgery, in combination with lifestyle changes, may be the best option for treating severely obese teens.

“The American Academy of Pediatrics supports the use of bariatric surgery in adolescents because the evidence shows it works and is safe. Pharmaceutical treatment options are very limited and have mixed results, and unfortunately for those who are already severely obese, the lifestyle changes won’t. be enough, “said the Messiah.

Bariatric surgery is minimally invasive surgery that alters the stomach or intestines to help obese patients lose weight.

Obtaining data from the American Society for Metabolic and Bariatric Surgery, the researchers found that although obese teens are turning to weight loss surgery as a way to lose a significant amount of weight, many of those who are severely obese, especially Hispanic and black teenagers, no such treatment option is offered.

“There is a big disconnect between those who undergo the surgery and those who need it. Research has shown that this is a safe and effective way to help these children get back on track, but the problem is that the surgery bariatric is not used to treat obesity among ethnic minority groups, ”Messiah said.

According to the study, more than 10% of Hispanic and black youth suffer from severe obesity in the United States, but their rates of completing weight loss surgery are well below those of white youth. The data used by the researchers shows that in 2018, 68.5% of young people who completed bariatric surgery were white, compared with 18.5% Hispanic and 15.5% black.

“More pediatricians need to refer these patients to surgeons if they are a good candidate to help their patients on a healthier path,” Messiah said.

Although bariatric surgery is an invasive treatment option and perhaps not an agreeable weight loss solution for many young people and their families, Messiah says it is an evidence-based safe option. “Research shows that readmission to hospital after surgery due to any complications is low. Of the surgeries performed between 2017 and 2018, only 3.4% of young patients were readmitted to hospital,” he said. called Messiah.

Despite the potential risks, Messiah said teens face diabetes, heart disease, asthma, hypertension, and psychological problems including anxiety, depression, and low self-esteem that studies have found to be associated with severe obesity in young people.

More recently, studies have shown that both adult and pediatric patients with obesity are at high risk of serious illness or death if they contract COVID-19.

“The bottom line is that most teens won’t lose weight on their own and using bariatric surgery is a safe and effective way to help treat this problem before it’s too late,” Messiah said. “We need to start taking action sooner so they can enter adulthood healthier.”