Ethnic variation in weight loss, but not co-morbidity remission, after laparoscopic gastric banding and Roux-en-Y gastric bypass

Surg Obes Relat Dis. Jan-Feb 2015;11(1):94-100. doi: 10.1016/j.soard.2014.07.013. Epub 2014 Jul 30.

Abstract

Background: Demographic factors such as ethnicity may affect bariatric surgery outcomes. We examined weight loss and co-morbidities outcomes in African American, Caucasian, and Hispanic patients who underwent laparoscopic gastric banding (LAGB) and Roux-en-Y gastric bypass (RYGB). The primary aim was to investigate demographic differences in weight loss and co-morbidities outcomes.

Methods: We retrospectively examined weight change and co-morbidities outcomes in our prospective database. A total of 1,903 patients underwent LAGB or RYGB between January 1, 2005 and March 31, 2012. Of those, 1828 completed their 1-year follow-up visit (9-15 mo) and had complete data. We excluded patients who were missing ethnicity information, resulting in a final cohort of 1,684 patients. Multivariate analyses and χ2 tests were used to examine demographic variables in body mass index (BMI) change, percent excess weight loss (%EWL), and remission of co-morbidities. We also examined weight loss outcomes at 2- and 3-year follow-up.

Results: Overall, those who underwent RYGB had a lower BMI and greater %EWL at 1, 2, and 3 years compared to those who had undergone LAGB. Overall, African American patients had a higher postoperative BMI than either Caucasian or Hispanic patients. African American patients also showed less %EWL than Caucasian and Hispanic patients. When we examined within surgery type, ethnic differences between African American and Caucasian patients were present across all 3 years in RYGB, but there were no ethnic differences by year 3 in LAGB. Additionally, African American and Hispanic patients no longer differed by year 3 in RYGB and by year 2 in LAGB. There were no significant ethnic differences in remission of diabetes, hyperlipidemia, hypertension, and sleep apnea at 1 year.

Conclusion: Our study found significant ethnic differences in the postoperative BMI and %EWL, which were more pronounced in patients undergoing RYGB than LAGB at the 3-year time point. These weight loss differences did not translate to a lower rate of co-morbidities remission.

Keywords: Bariatric surgery; Ethnicity; Gender; Race.

MeSH terms

  • Adult
  • African Americans / ethnology
  • Analysis of Variance
  • Diabetes Complications / complications
  • European Continental Ancestry Group / ethnology
  • Female
  • Gastric Bypass / methods*
  • Gastroplasty / methods*
  • Hispanic Americans / ethnology
  • Humans
  • Hyperlipidemias / complications
  • Hypertension / complications
  • Laparoscopy / methods*
  • Male
  • Middle Aged
  • Obesity, Morbid / complications
  • Obesity, Morbid / ethnology*
  • Obesity, Morbid / surgery
  • Prospective Studies
  • Retrospective Studies
  • Sleep Apnea, Obstructive / complications
  • United States / epidemiology
  • Weight Loss / ethnology*