Earnings and employment for women after bariatric surgery: a matched cohort study

Bariatric surgery induces durable weight loss and improves health and quality of life. Less is known about how bariatric surgery affects labour market outcomes. This study examined the development of earnings and employment status among women with obesity who underwent bariatric surgery versus matched comparators.

This study included two cohorts of women in Sweden who gave birth between 1992 and 2014: a cohort with bariatric patients and their full sisters (sister cohort) and a cohort with bariatric patients and comparators matched on BMI, education, birth year, and previous cardiovascular, psychiatric, and musculoskeletal inpatient care diagnoses (BMI-matched cohort). Taxable annual earnings were retrieved from the Swedish Income Tax Register from 2 years before to 5 years after surgery. Employment status was measured dichotomously (employed/not employed) based on earnings data. Adjusted mean and prevalence differences were estimated for earnings and employment by ordinary least squares regression.

The sister cohort included 1400 patient-sister pairs. At baseline, patients and their sisters were of similar age (38.3 vs. 38.6 years) but had different BMI (37.3 vs. 26.7 kg/m²). The BMI-matched cohort included 2967 patient-comparator pairs with similar age (36.1 vs. 36.2 years) and BMI (37.1 vs. 37.0 kg/m²) before surgery. During follow-up, similar developments of earnings and employment status were observed between bariatric patients and the comparators in both cohorts. When comparing absolute levels of earnings in the sister cohort, the difference in earnings at 2 years before surgery [mean difference -$4137 (95% CI -5245 to -3028)] was similar to the difference in earnings at 5 years after surgery [-$5620 (-7024 to -4215)]. Similar results were found in the BMI-matched cohort, but of smaller magnitude.

Bariatric surgery had little influence on the development of annual earnings and employment for women with obesity in Sweden over 5 years after surgery.