Surgical Treatment of Obesity in Latinos and African Americans: Future Directions and Recommendations to Reduce Disparities in Bariatric Surgery

doi:10.1089/bari.2017.0037

. 2018 Mar 1;13(1):2-11.

doi: 10.1089/bari.2017.0037.

Surgical Treatment of Obesity in Latinos and African Americans: Future Directions and Recommendations to Reduce Disparities in Bariatric Surgery

Emily Daviau Smith^{1

2}, Brian T Layden^{1

2}, Chandra Hassan³, Lisa Sanchez-Johnsen^{3

4}

Affiliations

¹ Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Illinois at Chicago, Chicago, Illinois.
² Jesse Brown Veterans Affairs Medical Center, Chicago, Illinois.
³ Department of Surgery, University of Illinois at Chicago, Chicago, Illinois.
⁴ Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois.

PMID: 32612896
PMCID: PMC7325708
DOI: 10.1089/bari.2017.0037

Surgical Treatment of Obesity in Latinos and African Americans: Future Directions and Recommendations to Reduce Disparities in Bariatric Surgery

Emily Daviau Smith et al. Bariatr Surg Pract Patient Care. 2018.

. 2018 Mar 1;13(1):2-11.

doi: 10.1089/bari.2017.0037.

Authors

Emily Daviau Smith^{1

2}, Brian T Layden^{1

2}, Chandra Hassan³, Lisa Sanchez-Johnsen^{3

4}

Affiliations

¹ Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Illinois at Chicago, Chicago, Illinois.
² Jesse Brown Veterans Affairs Medical Center, Chicago, Illinois.
³ Department of Surgery, University of Illinois at Chicago, Chicago, Illinois.
⁴ Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois.

PMID: 32612896
PMCID: PMC7325708
DOI: 10.1089/bari.2017.0037

Abstract

Introduction: Obesity and metabolic syndrome are increasingly prevalent in the United States, particularly among African Americans and Latinos. Bariatric surgery has become one of the primary treatment modalities for obesity and type 2 diabetes. However, fewer Latinos and African Americans are undergoing bariatric surgery than whites. The aim of this article is to describe the disparities in seeking and accessing bariatric surgery, describe the outcomes following bariatric procedures in Latinos and African Americans, and offer recommendations and future research directions that may assist in addressing these disparities. Methods: Original research and review articles published in English were reviewed. Results: Potential reasons why Latinos and African Americans have low rates of seeking bariatric surgery are described. Disparities in access to care and financial coverage, low rates of referral by primary care providers, and cultural attitudes toward obesity in conjunction with mistrust of the healthcare system are discussed as potential contributors to the low rate of bariatric surgery in Latinos and African Americans. Finally, disparities in bariatric surgery outcomes, comorbidities, and complications are reviewed. Conclusions: Additional research studies in bariatric surgical disparities are needed. Recommendations and future directions that may help to reduce disparities in bariatric surgery are discussed.

Keywords: African Americans/blacks; Hispanics/Latinos; disparities.

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Conflict of interest statement

No competing financial interests exist.

Figures

<b>FIG. 1.</b> — **FIG. 1.**
The weighted prevalence of obesity (BMI ≥30) and severe obesity (BMI ≥40) in the United States across race and Hispanic origin (age adjusted) as noted in the 2013–2014 2-year cycle of the continuous NHANES. Adapted from Flegal *et al.* NHANES, National Health and Nutrition Examination Survey. Normal Weight / Overweight (BMI <30) Obese (BMI ≥30) Severe Obesity (BMI ≥40)

formula image — **FIG. 1.**
The weighted prevalence of obesity (BMI ≥30) and severe obesity (BMI ≥40) in the United States across race and Hispanic origin (age adjusted) as noted in the 2013–2014 2-year cycle of the continuous NHANES. Adapted from Flegal *et al.* NHANES, National Health and Nutrition Examination Survey. Normal Weight / Overweight (BMI <30) Obese (BMI ≥30) Severe Obesity (BMI ≥40)

<b>FIG. 2.</b> — **FIG. 2.**
The estimated prevalence of metabolic syndrome across race and Hispanic origin. Adapted from Aguilar *et al.* Metabolic Syndrome Does Not Meet Criteria for Metabolic Syndrome

See this image and copyright information in PMC

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References

1. Flegal KM, Kruszon-Moran D, Carroll MD, Fryar CD, Ogden CL. Trends in Obesity Among Adults in the United States, 2005 to 2014. JAMA 2016;315:2284–2291 - PMC - PubMed
1. Aguilar M, Bhuket T, Torres S, Liu B, Wong RJ. Prevalence of the metabolic syndrome in the United States, 2003–2012. JAMA 2015;313:1973–1974 - PubMed
1. Ikramuddin S, Korner J, Lee WJ, et al. . Roux-en-Y gastric bypass vs intensive medical management for the control of type 2 diabetes, hypertension, and hyperlipidemia: the Diabetes Surgery Study randomized clinical trial. JAMA 2013;309:2240–2249 - PMC - PubMed
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[1] Flegal KM, Kruszon-Moran D, Carroll MD, Fryar CD, Ogden CL. Trends in Obesity Among Adults in the United States, 2005 to 2014. JAMA 2016;315:2284–2291 - PMC - PubMed

[2] Flegal KM, Kruszon-Moran D, Carroll MD, Fryar CD, Ogden CL. Trends in Obesity Among Adults in the United States, 2005 to 2014. JAMA 2016;315:2284–2291 - PMC - PubMed

[3] Aguilar M, Bhuket T, Torres S, Liu B, Wong RJ. Prevalence of the metabolic syndrome in the United States, 2003–2012. JAMA 2015;313:1973–1974 - PubMed

[4] Aguilar M, Bhuket T, Torres S, Liu B, Wong RJ. Prevalence of the metabolic syndrome in the United States, 2003–2012. JAMA 2015;313:1973–1974 - PubMed

[5] Ikramuddin S, Korner J, Lee WJ, et al. . Roux-en-Y gastric bypass vs intensive medical management for the control of type 2 diabetes, hypertension, and hyperlipidemia: the Diabetes Surgery Study randomized clinical trial. JAMA 2013;309:2240–2249 - PMC - PubMed

[6] Ikramuddin S, Korner J, Lee WJ, et al. . Roux-en-Y gastric bypass vs intensive medical management for the control of type 2 diabetes, hypertension, and hyperlipidemia: the Diabetes Surgery Study randomized clinical trial. JAMA 2013;309:2240–2249 - PMC - PubMed

[7] Mingrone G, Panunzi S, De Gaetano A, et al. . Bariatric-metabolic surgery versus conventional medical treatment in obese patients with type 2 diabetes: 5 year follow-up of an open-label, single-centre, randomised controlled trial. Lancet 2015;386:964–973 - PubMed

[8] Mingrone G, Panunzi S, De Gaetano A, et al. . Bariatric-metabolic surgery versus conventional medical treatment in obese patients with type 2 diabetes: 5 year follow-up of an open-label, single-centre, randomised controlled trial. Lancet 2015;386:964–973 - PubMed

[9] Dixon JB, O'Brien PE, Playfair J, et al. . Adjustable gastric banding and conventional therapy for type 2 diabetes: a randomized controlled trial. JAMA 2008;299:316–323 - PubMed

[10] Dixon JB, O'Brien PE, Playfair J, et al. . Adjustable gastric banding and conventional therapy for type 2 diabetes: a randomized controlled trial. JAMA 2008;299:316–323 - PubMed

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Surgical Treatment of Obesity in Latinos and African Americans: Future Directions and Recommendations to Reduce Disparities in Bariatric Surgery

Affiliations

Surgical Treatment of Obesity in Latinos and African Americans: Future Directions and Recommendations to Reduce Disparities in Bariatric Surgery

Authors

Affiliations

Abstract

Conflict of interest statement

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