Are male patients undergoing bariatric surgery less healthy than female patients?

Nienke van Olst; Beata M M Reiber; Marjolein R A Vink; Victor E A Gerdes; Henrike Galenkamp; Donald L van der Peet; Anne-Sophie van Rijswijk; Sojoerd C Bruin

doi:10.1016/j.soard.2023.02.015

Are male patients undergoing bariatric surgery less healthy than female patients?

Surg Obes Relat Dis. 2023 Sep;19(9):1013-1022. doi: 10.1016/j.soard.2023.02.015. Epub 2023 Feb 24.

Authors

Nienke van Olst¹, Beata M M Reiber², Marjolein R A Vink³, Victor E A Gerdes⁴, Henrike Galenkamp⁵, Donald L van der Peet², Anne-Sophie van Rijswijk², Sojoerd C Bruin³

Affiliations

¹ Department of Bariatric Surgery, Spaarne Gasthuis, Hoofddorp, the Netherlands; Department of Surgery, Amsterdam University Medical Centers, Amsterdam, the Netherlands. Electronic address: nvanolst@spaarnegasthuis.nl.
² Department of Surgery, Amsterdam University Medical Centers, Amsterdam, the Netherlands.
³ Department of Bariatric Surgery, Spaarne Gasthuis, Hoofddorp, the Netherlands.
⁴ Department of Bariatric Surgery, Spaarne Gasthuis, Hoofddorp, the Netherlands; Department of Vascular Medicine, Amsterdam University Medical Centers, Amsterdam, the Netherlands.
⁵ Department of Public and Occupational Health, Amsterdam University Medical Centers, Amsterdam, the Netherlands; Health Behaviors and Chronic Diseases, Amsterdam Public Health, Amsterdam, the Netherlands.

PMID: 36967264
DOI: 10.1016/j.soard.2023.02.015

Abstract

Background: Male patients are underrepresented in bariatric surgery (BS) despite a relatively equal proportion of men and women experiencing obesity.

Objectives: Differences in frequency and severity of obesity-associated medical problems (OAMPs) between men and women undergoing BS or in a control group (HELIUS [HEalthy Life In an Urban Setting]) were evaluated. The hypothesis was that men undergoing BS are less healthy than women.

Setting: A cross-sectional study of 2 cohorts undergoing BS in 2013 (BS2013) and 2019 (BS2019) and a control group of patients with severe obesity from a general population (HELIUS).

Methods: Characteristics concerning weight and OAMPs, medication usage, intoxications, postoperative complications (for BS2019) were compared between men and women. Members of the HELIUS cohort were tested for eligibility for BS.

Results: Of 3244 patients included, the majority were female (>78.4%). Median (interquartile range) age and body mass index (kg/m²) in male versus female patients were 47.0 (41.0-53.8) versus 43.0 (36.0-51.0) years and 41.5 (38.4-45.2) versus 42.3 (40.2-45.9), respectively, in BS2013, and 52.0 (39.8-57.0) versus 45.0 (35.0-53.0) years and 40.4 (37.4-43.8) versus 41.3 (39.0-44.1) in BS2019 (P < .05). The rates of men with OAMPs were 71.4% and 82.0% compared with 50.2% and 56.9% of women in BS2013 and BS2019, respectively. Overall medication usage was higher in male patients (P = .014). In BS2019, male patients exhibited a higher median HbA1C (P < .001) and blood pressure (P = .003) and used more antihypertensives and antidiabetics (P = .004). Postoperative complications did not differ between men and women. In the control cohort, 66.5% of men and 66.6% of women were eligible for BS.

Conclusion: Men undergoing BS more often experience OAMPs than women, and OAMPs are more advanced in men.

Keywords: Bariatric surgery; Gender; Obesity-associated medical problems; One-anastomosis gastric bypass; Roux-en-Y gastric bypass; Sex; Sleeve gastrectomy.

MeSH terms

Bariatric Surgery* / adverse effects
Cross-Sectional Studies
Female
Gastrectomy
Gastric Bypass*
Humans
Laparoscopy*
Male
Obesity, Morbid* / complications
Postoperative Complications / surgery
Retrospective Studies
Weight Loss