A recent study by Mass General Brigham investigators revealed ongoing racial and increasing sex disparities in the discussions and reception of weight loss surgery over 20 years. Researchers emphasize the need for interventions to ensure equitable access to metabolic and bariatric surgery.
A new study by Mass General Brigham has uncovered striking trends in the realm of weight loss surgery, revealing persistent racial disparities and an alarming rise in sex disparities over the past two decades. The research, which analyzed the medical records of over 120,000 patients, indicates a pressing need for interventions to ensure that all patients, irrespective of race or gender, receive the care they need.
The findings, recently published in Annals of Surgery Open, show that Black patients are significantly less likely than their non-Black counterparts to undergo metabolic and bariatric surgery (MBS), despite having comparable rates of discussions about the surgery with health care providers. Alarmingly, men are less likely to both discuss and receive MBS than women, highlighting a growing sex disparity in treatment.
“As a clinician, I often see patients who could potentially benefit from MBS but who aren’t aware of this treatment option. Patients who discuss MBS are much more likely to undertake it and lose weight,” corresponding author Alexander Turchin, M.D., MS, the director of Quality in Diabetes at the Division of Endocrinology, Diabetes and Hypertension at Brigham and Women’s Hospital, said in a news release. “Our findings indicate that we need to improve these conversations and identify barriers to undergoing surgery once it has been discussed.”
Obesity remains a critical public health crisis in the United States, affecting more than 40% of adults and nearly 50% of Black Americans. Despite MBS being recognized as the most effective long-term solution for severe obesity, fewer Black and male patients are pursuing this treatment.
This research sheds light on how these disparities have evolved from patient visits over time.
The investigators utilized an advanced artificial intelligence tool to evaluate the electronic health records of 122,487 adults with class 2 obesity and higher, treated at Mass General Brigham between 2000 and 2022.
They noted a promising increase in annual patient-provider MBS discussions, rising from 3.2% to 10% over the study period.
However, only a small fraction of these discussions led to surgery. Specifically, while 74% of patients first explored MBS with primary care physicians, only 1,348 out of 11,094 patients who discussed MBS proceeded with the surgery.
Racial disparities decreased slightly over the study period, but they remained significant. Only 8.4% of Black patients who discussed MBS underwent surgery, compared to 12.6% of their non-Black peers.
The gender gap widened even further, with men being less likely to discuss and receive MBS than women, highlighting the need for gender-specific interventions.
“Providers need to ensure that patients have all the available information to make decisions about obesity treatments,” added Turchin. “Future studies will be required to understand how the advent of new medications to treat obesity, such as GLP-1 agonists, impacts patient-provider discussions about MBS.”
The study underscores the importance of patient-provider communication and calls for strategies to reduce these disparities. Addressing these gaps is crucial for improving health outcomes and ensuring equity in obesity treatment.