E. M. Masterson1, F. Halperin2, A. Tavakkoli2 1Wake Forest University School Of Medicine,Winston-Salem, NC, USA 2Brigham And Women’s Hospital,Boston, MA, USA
Introduction:
Despite increasing obesity rates in both males and females, females continue to participate in commercial weight loss programs, receive medical weight loss counseling, and undergo bariatric surgery procedures at disproportionately higher rates. Reasons for this are multifactorial and includes patient and provider biases. It is of interest to both physicians and surgeons to better understand these biases to help better serve this patient population, and increase the rate of bariatric surgery uptake from current 1-2%.
Methods:
The study retrospectively reviewed electronic health records and customized paper surveys for 300 new patients seen at our Center for Weight Management and Metabolic Surgery (CWMMS) . All new patients between July 2016 and February 2017 were included in the study. Data collected included patient demographics (age, BMI, gender, comorbidities), treatment (diet and exercise counseling, pharmacotherapy, bariatric referrals), and outcomes (weight loss, referrals, bariatric procedures). All patient data was input to and analyzed using REDCap an online, HIPPA-compliant database.
Results:
79.3% (n=238) of patients seen were female. Based on BMI and comorbidities, 57.7% (n=173) of all patients qualified for bariatric surgery at their initial visit. Interestingly, a much higher percentage of male patients qualified for bariatric surgery than women (77.4% vs. 52.5% respectively; p<0.001). Of the 173 patients meeting surgical criteria, 26.0% (n=45) were referred for bariatric surgery consultation at an initial or follow-up visit, with no difference between male and female referral rates (31.3% vs. 24.0% respectively, p=0.33). Within the study time frame (July 2016- June 2017), a total of 14 patients underwent a bariatric procedure, representing 8.1% of qualified patients and 31.1% of referred patients. 78.6% of patients receiving a bariatric procedure were female.
Conclusion:
At an urban academic medical center, males referred for weight management consults were more likely to qualify for bariatric surgery at the initial visit. Although men were equally likely to be referred to bariatric surgery, they were less likely to undergo weight loss operations compared to females. These results highlight that (1) Males are referred to medical weight loss programs by primary care or specialty physicians at higher BMIs and (2) Males and females were equally likely to agree to referral to a bariatric clinic, but men were less likely to proceed with surgery. Studies with longer follow up time and sample population are necessary to extend these findings to other weight management centers, but these initial findings highlight gender discrepancies in medical weight management and bariatric surgery referrals and procedures.
