Socioeconomic predictors of weight loss after laparoscopic Roux-Y gastric bypass.
BACKGROUND
Successful weight loss after laparoscopic Roux-Y gastric bypass (LRYGB) hinges on many elements including neurohormonal, anatomical, and postoperative behavioral changes. To date, the effects of socioeconomic factors have been inadequately studied. We examine several components of socioeconomic status and its relationship to weight loss after LRYGB.


METHODS
Between August 2002 and July 2006, 405 LRYGB were performed by a single surgeon. Patient demographics were entered into a longitudinal, prospective database. At 1-year follow-up, 309 patients were available for analysis. Regional median household income (RMAHI) and primary insurance carrier were used as surrogates for preoperative socioeconomic status. Analysis of covariance (ANCOVA) test was used for statistical analysis. According to RMAHI, we divided the patients into three groups: US $20,001-40,000 (group A, n = 67), US $40,001-60,000 (group B, n = 153), and more than US $60,000 (group C, n = 89). Initial body mass index (BMI) was 52.76 +/- 1.01, 51.28 +/- 0.67, and 48.87 +/- 0.94 kg/m2, respectively. Additionally, patients were divided according to private insurance or state-based insurance. A total of 274 patients had private insurance, with an initial mean BMI of 50.6 kg/m2, and 35 patients had state-based insurance, with an initial BMI of 53.0 kg/m2.


RESULTS
After 1 year, weight loss in groups A, B and C was 110.6 +/- 4.3, 110.0 +/- 2.5, and 103.9 +/- 3.6 lb with BMI decrease of 17.7 +/- 0.6, 17.7 +/- 0.4, and 16.9 +/- 0.6 kg/m2, respectively. Weight loss in the private insurance group was 49.2 +/- 0.9 kg compared with 50.2 +/- 2.3 kg in the state-based group with BMI decrease of 17.4 +/- 0.3 and 18.4 +/- 0.8 kg/m2, respectively. There were no statistical significances in the effect of socioeconomic status, median household income, and insurance carrier on postoperative weight loss.


CONCLUSIONS
With appropriate patient selection, the socioeconomic status of patients undergoing LRYGB does not affect postoperative weight loss.
Akkary
Ehab
E
Yale University School of Medicine, New Haven, CT, USA. ehabakkary@yahoo.com
Nerlinger
Abby
A
Yu
Sunkyung
S
Dziura
James
J
Duffy
Andrew J
AJ
Bell
Robert L
RL
D000328:Adult; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D007182:Income / Q000706:statistics & numerical data*; D007348:Insurance, Health / Q000191:economics*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D009765:Obesity / Q000191:economics / Q000601:surgery*; D011184:Postoperative Period; D011379:Prognosis; D011446:Prospective Studies; D012959:Socioeconomic Factors; D013997:Time Factors; D015431:Weight Loss / Q000502:physiology*