Disparity Between United States Adolescent Class II and III Obesity Trends and Bariatric Surgery Utilization, 2015-2018
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Read the article on pubmed.ncbi.nlm.nih.gov ↗Article · Nov 2020 · 1 min read
In brief
In brief
This study reveals significant underutilization of metabolic and bariatric surgery among US adolescents with severe obesity (1.81 per 1,000) compared to adults (5.56 per 1,000), with marked racial and ethnic disparities. Despite rising severe obesity rates in Hispanic and Black youth, non-Hispanic white adolescents receive MBS at substantially higher rates, highlighting critical gaps in access to this safe and effective treatment.
Written by the GCMD Library team from the article.
Objectives: Severe obesity is the fastest growing subcategory of obesity in the United States (US) pediatric population. Metabolic and bariatric surgery (MBS) is a safe and effective treatment option for severe obesity. The primary objectives of this analysis were to determine the (1) current US MBS utilization rates in those with severe obesity; and (2) utilization rates and 30-day post-operative outcomes.
Summary background data: The 2015-2018 National Health and Nutrition Examination Survey (NHANES) cross-sectional data (N = 19,225) generated US severe obesity prevalence estimates. The 2015-2018 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) longitudinal (30 day) cohort data was used to compare adolescent and adult (N = 760,076) post-operative outcomes and to calculate utilization rates.
Methods: The 2015-2018 youth and adult MBS utilization rates were calculated using MBSAQIP data (numerator) and NHANES data (denominator). Two-sample tests of proportions were performed to compare the MBS utilization rates by age, ethnicity and sex and expressed per 1,000.
Results: Mean age of the analytical MBSAQIP sample was 17.9 (1.15) years in youth (n = 3,846) and 45.1 (11.5) in adults (N = 744,776), majority female (77.4%, 80.7%, respectively) and non-Hispanic white (68.5%, 59.4%, respectively). The overall 2015-2018 MBS utilization rate for youth was 1.81 per 1,000 and 5.56 per 1,000 for adults (P < .001). Adult patients had slightly higher percentage (4.2%) of hospital readmissions compared to youth (3.4%, P = .01) but there were no other post-MBS complication differences. From 2015-2018 the US prevalence of youth severe obesity increased in Hispanics and non-Hispanic blacks (P-trend < .001), but non-Hispanic whites had higher rates of MBS utilization (45.8%) compared to Hispanics (22.7%) and non-Hispanic blacks 14.2% (P = .006).
Conclusions: MBS is an underutilized obesity treatment tool for both youth and adults, and among ethnic minority groups in particular.
DOI: 10.1097/SLA.0000000000004493