Disparities in Complication Rates Among Ethnic Minorities Undergoing Bariatric Surgery in the UK

Mohamed Aly; Fahad Iqbal; Aruna Munasinghe; Omer Al-Taan; Richard Welbourn; Omar Khan; Chanpreet Arhi; Alan Askari

doi:10.1007/s11695-025-07845-1

Disparities in Complication Rates Among Ethnic Minorities Undergoing Bariatric Surgery in the UK

Obes Surg. 2025 Apr 4. doi: 10.1007/s11695-025-07845-1. Online ahead of print.

Authors

Mohamed Aly^{1

2}, Fahad Iqbal³, Aruna Munasinghe⁴, Omer Al-Taan⁴, Richard Welbourn⁵, Omar Khan⁶, Chanpreet Arhi⁷, Alan Askari⁴

Affiliations

¹ The Hillingdon Hospitals NHS Foundation Trust, London, UK. m.aly@nhs.net.
² Brunel University London, London, UK. m.aly@nhs.net.
³ Imperial College London, London, UK. fmiqbal786@gmail.com.
⁴ Bedfordshire Hospitals NHS Foundation Trust, Luton, UK.
⁵ Somerset NHS Foundation Trust, University of Bristol, Bristol, Taunton, UK.
⁶ St. George's University Hospitals NHS Foundation Trust, London, UK.
⁷ West Hertfordshire Hospitals NHS Trust, Watford, UK.

PMID: 40185955
DOI: 10.1007/s11695-025-07845-1

Abstract

Background: Ethnicity may play a significant role in determining surgical outcomes. This study examines the disease profiles across ethnic groups and investigates whether ethnicity influences the risk of complications following bariatric surgery.

Methods: Data from the United Kingdom's National Bariatric Surgery Registry (NBSR) were analysed, encompassing all adult patients undergoing bariatric procedures. Comparative analyses were performed, and a multivariable regression model was developed to identify factors associated with postoperative complications.

Results: A total of 77,710 (78.8% female) patients were included in the analysis, with a median age of 46 (IQR 37-55) years. Most patients were Caucasian (91.6%), followed by Asian (4.1%), Afro-Caribbean (2.5%), and African (1.7%) groups. Afro-Caribbean patients had the highest median BMI (44.5 kg/m²) and the highest prevalence of hypertension (43.2%), while Asian patients were younger (median age 41 years) and had a higher prevalence of diabetes mellitus (29.1%). African and Afro-Caribbean patients were less likely to self-fund their procedures (14.9% and 10.6%, respectively) compared to Caucasians (25.9%). Complication rates were the highest among Afro-Caribbean patients (5.8 vs 4.8%, p < 0.001) compared to Caucasians. Multivariable regression analysis identified ethnicity as an independent predictor of postoperative complications, with Afro-Caribbean (OR 1.47, 95% CI 1.22-1.87, p < 0.001) and African (OR 1.34, 95% CI 1.05-1.70, p = 0.019) patients demonstrating significantly increased risks.

Conclusions: This registry analysis identified ethnic disparities in disease profiles and postoperative outcomes among bariatric surgery patients in the UK, underscoring the need for targeted health policies to improve outcomes in these vulnerable populations.

Keywords: Bariatric Surgery; Ethnicity; Health Disparities / Healthcare Inequalities; National Bariatric Surgery Registry (NBSR); Obesity; Surgical Outcomes / Postoperative Complications.