T. Boland1, J. Lau1 1Loyola University Chicago Stritch School Of Medicine, Surgery, Maywood, IL, USA
Introduction:
Obesity was declared an epidemic in the United States by the Center for Disease Control and Prevention in 1999 and has remained an epidemic since The prevalence of obesity has risen to 41.9% in the years 2017-2020. Obesity has many associated comorbidities including, but are not limited to, diabetes mellitus (DM), hypertension, cerebrovascular disease, dyslipidemia, and cancer, some of which are the leading causes of death. Obesity also plays a significant role in the economic burden with an annual cost of roughly $173 billion dollars in 2019.
It has been shown that bariatric surgery is the most sustainable form of weight loss, however only about 250,000 patients underwent bariatric surgery in 2018. Bariatric surgery can help reduce hemoglobin A1c and triglyceride levels, while also reducing the risk of cancer Despite the benefits, there are a number of barriers that patients face before they can pursue bariatric surgery. Specifically, studies have suggested that patients with a low socioeconomic status were less likely to undergo bariatric surgery due to limited insurance coverage and high out-of-pocket costs.
Methods:
New patients that visited a single institution bariatric clinic for surgical weight loss from the dates 1/3/2019-6/30/2023 were reviewed. Demographics such as age,sex, race, insurance were collected in addition to whether patients were referred to the clinic by a physician or were self-referrals.
Results:
The study assessed 3,486 patients referred for bariatric surgery, comprising 2,673 physician referrals and 813 self-referrals. Demographic analysis revealed no significant age difference between groups (p = 0.43), with median ages of 50 and 49 years, respectively. Gender distribution was similar, with females constituting 68.54% of physician referrals and 67.16% of self-referrals (p = 0.46). Racial demographics showed no significant differences (p = 0.18), with the majority being White (52.60% vs. 51.62%). Insurance status indicated a higher prevalence of self-pay among self-referrals (1.97% vs. 0.49%, p < 0.001). Employment status differed significantly (p < 0.001), with higher rates of retirement (25.71% vs. 19.26%) and unemployment (28.35% vs. 24.76%) among self-referrals. Specialty analysis of referring physicians highlighted internal medicine as the most common specialty (26.99%), with significant differences in specialty distribution (p < 0.001). These findings suggest financial and employment status influence the likelihood of self-referral for bariatric surgery.
Conclusion:
Obesity remains a significant public health and economic burden in the United States, with bariatric surgery recognized as the most sustainable weight loss solution. The study highlights that self-referrals for bariatric surgery are more common among self-paying and retired individuals, indicating that financial and employment status significantly influence the likelihood of pursuing this treatment.