title: Disparities in Treatment Uptake and Outcomes of Patients with Obesity in the USA.
abstract: There are clear and persistent disparities in obesity prevalence within the USA. Some of these disparities fall along racial/ethnic lines; however, there are a number of other social and demographic constructs where obesity disparities are present. In addition to differing rates of obesity across groups, there is growing evidence that subgroups of patients both seek out and respond to obesity treatment differently. This review article explores the epidemiology of obesity disparities, as well as the existing evidence around how different groups may respond to behavioral, medical, and surgical therapies, and potential reasons for differential uptake and response, from culture, to access, to physiology. We find that the vast majority of evidence in this area has focused on the observation that African Americans tend to lose less weight in clinical trials compared to non-Hispanic whites and mainly pertains to behavioral interventions. Moving forward, there will be a need for studies that broaden the notion of health disparity beyond just comparing African Americans and non-Hispanic whites. Additionally, a more thorough examination of the potential for disparate outcomes after medical and surgical treatments of obesity is needed, coupled with the careful study of possible physiologic drivers of differential treatment response.
authors.affiliation: Department of Epidemiology and Prevention, Division of Public Health Sciences, Weight Management Center, Wake Forest Baptist Medical Center, Winston-Salem, NC, 27157, USA.
authors.forename: Kristina H
authors.initials: KH
authors.lastname: Lewis
authors.affiliation: Department of General Surgery, Weight Management Center, Wake Forest Baptist Medical Center, Winston-Salem, NC, 27157, USA.
authors.forename: Shenelle A
authors.initials: SA
authors.lastname: Edwards-Hampton
authors.affiliation: Department of Epidemiology and Prevention, Division of Public Health Sciences, Weight Management Center, Wake Forest Baptist Medical Center, Winston-Salem, NC, 27157, USA. jard@wakehealth.edu.
authors.forename: Jamy D
authors.initials: JD
authors.lastname: Ard
mesh_terms: D001741:Black or African American; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D005006:Ethnicity; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006630:Hispanic or Latino; D006801:Humans; D009765:Obesity / Q000453:epidemiology* / Q000517:prevention & control; D018579:Patient Selection; D015995:Prevalence; D011787:Quality of Health Care; D014481:United States / Q000453:epidemiology; D044465:White People
keywords: African American; Anti-obesity pharmacotherapy; Bariatric surgery; Behavioral intervention; Culture; Disparities; Ethnicity; Genetic admixture; Lifestyle modification; Obesity; Obesity prevalence; Race; Treatment access; Treatment adherence