Is social deprivation associated with weight loss outcomes following bariatric surgery? A 10-year single institutional experience.
BACKGROUND
Social deprivation is associated with a greater morbidity and shorter life expectancy. This study evaluates differences in weight loss following bariatric surgery and deprivation, based on UK deprivation measures in a London bariatric centre.


METHODS
All patients undergoing bariatric surgery between 2002 and 2012 were retrospectively identified. Demographic details, type of surgery and percentage excess weight loss data were collected. UK Index of Multiple Deprivation (IMD, 2010) and IMD domain of the Health Deprivation and Disability (HDD) scores were used to assess deprivation (where 1 is the most deprived in rank order and 32,482 is the least deprived). Two-way between-subjects analysis of variance (ANOVA) was performed to examine the effect of IMD score, deprivation, procedure type and gender on percentage excess weight loss.


RESULTS
Data were included from 983 patients (178 male, 805 female) involving 3,663 patient episodes. Treatments comprised laparoscopic gastric bands (n=533), gastric bypass (n=362) and gastric balloons (n=88). The average percentage excess weight loss across all procedures was 38 % over a follow-up period (3 months-9 years). There was no correlation between weight loss and IMD/HDD rank scores. Gastric bypass was significantly more effective at achieving weight loss than the other two procedures at 3-, 6- and 9-month and 1-year follow-up.


CONCLUSIONS
Social deprivation does not influence weight loss after bariatric surgery, suggesting that all socioeconomic groups may equally benefit from surgical intervention. Social deprivation should not therefore negatively influence the decision for surgical intervention in these patients.
The Department of Bariatric and Metabolic Surgery, Chelsea and Westminster NHS Foundation Trust, 369 Fulham Road, London, SW10 9NH, UK.
Maryam
M
Alfa Wali
Hutan
H
Ashrafian
Kerry L
KL
Schofield
Leanne
L
Harling
Abdullah
A
Alkandari
Ara
A
Darzi
Thanos
T
Athanasiou
Thanos
T
Athansiou
Evangelos
E
Efthimiou
D000328:Adult; D050110:Bariatric Surgery / Q000379:methods; D016208:Databases, Factual; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000523:psychology / Q000601:surgery*; D012189:Retrospective Studies; D012934:Social Isolation; D013222:State Medicine; D016896:Treatment Outcome; D015431:Weight Loss