title: Benefits of bariatric surgery do not reach obese men.
abstract: BACKGROUND
  Epidemiological studies have shown an equal gender distribution of obesity in the United States; however, literature suggests approximately 80% of patients undergoing bariatric surgery are female. The aim of this study is to identify factors that contribute to this gender disparity.
  
  
  METHODS
  A retrospective analysis of the Nationwide Inpatient Sample was performed. Obese patients who underwent open or laparoscopic gastric bypass or sleeve gastrectomy were identified using International Classification of Diseases, 9th edition codes. Patients <18 years of age were excluded. Female gender was used as a dependent variable to determine factors that influence gender distribution. Multivariate analyses adjusted for age, race, state within the United States, Charlson Comorbidity Index, income level, and insurance status.
  
  
  RESULTS
  From 1998 to 2010, 190,705 patients underwent bariatric surgery (93% gastric bypass, 7% sleeve gastrectomy). Females made up 81.36% of the population. An 80% to 20% female to male distribution was maintained for every year (1998-2010) and was unchanged within individual states. Patients were more likely to be female if from a lower-income neighborhood or if African American or Hispanic (P<.05). Patients were less likely to be female with increasing age, more comorbidities, or private insurance (P<.05).
  
  
  CONCLUSIONS
  The unequal gender distribution in bariatric surgery patients is influenced by demographic and socioeconomic factors. This disparity is narrowed in patients who are older and have more comorbidities, whereas the disparity is widened for certain races and lower incomes. Given the equal distribution of obesity in the United States, the widespread gender gap in bariatric surgery may suggest an underuse in obese men.
authors: 1 Center for the Future of Surgery, Division of Minimally Invasive Surgery, Department of Surgery, University of California , San Diego, San Diego, California.
authors: Hans F
authors: HF
authors: Fuchs
authors: Ryan C
authors: RC
authors: Broderick
authors: Cristina R
authors: CR
authors: Harnsberger
authors: David C
authors: DC
authors: Chang
authors: Bryan J
authors: BJ
authors: Sandler
authors: Garth R
authors: GR
authors: Jacobsen
authors: Santiago
authors: S
authors: Horgan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005743:Gastrectomy / Q000379:methods / Q000706:statistics & numerical data*; D015390:Gastric Bypass / Q000379:methods / Q000706:statistics & numerical data*; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D010535:Laparoscopy / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009767:Obesity, Morbid / Q000601:surgery*; D012189:Retrospective Studies; D017678:Sex Distribution; D012737:Sex Factors; D012959:Socioeconomic Factors; D014481:United States; D055815:Young Adult