The Effect of Insurance Status on Bariatric Surgery Outcomes: A Retrospective Chart Review Study

Abstract

Background Prior studies have shown socioeconomic factors and race to affect weight loss after bariatric surgery, but few have focused on the impact of insurance status. The purpose of this study was to determine if insurance status affects bariatric surgery patients’ surgical outcomes and weight loss. Methods A retrospective review was conducted of 408 bariatric patients who underwent laparoscopic Roux-en-Y gastric bypass (LRYGB) or sleeve gastrectomy (SG). Patients were stratified by insurance status and surgery type to evaluate weight loss and surgical outcomes. Results Overall, patients experienced 71.0% excess weight loss at 1-year postoperatively. Patients undergoing LRYGB had greater percent excess weight loss (%EWL) at 1-year (74.5% vs 63.3%, P < .001) than SG patients. Upon multiple regression analysis, insurance type did not affect %EWL. Instead, younger age, female gender, LRYGB procedure, and lower initial BMI were all associated with greater %EWL. Conclusions Insurance type is not a useful independent predictor of successful weight loss in bariatric surgery patients.

The long weight: association between distressed communities index and long-term weight outcomes following bariatric surgery

“…However, LT patients were more likely to have public insurance and undergo RYGB. Univariate analysis showed greater 1-year weight loss among LT patients; however, this was not statistically significant on multivariate analysis, consistent with other studies which showed SES did not affect short-term weight outcomes [ 7 , 11 , 17 ]. This finding is encouraging as it indicates that, despite poorer resources, LT patients can have the same short-term weight loss benefits as their HT counterparts.…”

“…It is crucial to understand the risk factors that affect weight outcomes, especially since the magnitude and maintenance of weight loss significantly impacts improvement in metabolic health and obesity-associated comorbidities. SES has been implicated as one such risk factor, but measures of SES and its effect on weight loss have been variable [ 5 , 7 , 9 , 10 ]. Given its role as a comprehensive measure for SES, we used DCI as a means to better understand the impact of SES on weight loss and weight recurrence after bariatric surgery.…”

“…Several studies have identified age, sex, and initial body mass index (BMI) as risk factors for weight recurrence following bariatric surgery [ 7 – 9 ]. Socioeconomic status (SES) has also been identified as a risk factor for poor long-term post-bariatric outcomes; however, its association with long-term weight outcomes remains mixed [ 10 – 15 ] .…”

Sex dimorphism in the effect and predictors of weight loss after sleeve gastrectomy

“…In female patients, age is negatively associated with weight-loss outcomes, as has been demonstrated in a large number of studies ( 26 – 29 ). The basal energy expenditure has a tendency to decrease tremendously with age, switching from 60 to 70% of total metabolism around the age of 20–30 to 40% at the age of 50 ( 30 ).…”