The Association between Bariatric Surgery Outcomes and Socioeconomic Deprivation

Obesity is a multifaceted problem for global healthcare, influenced by socioeconomic factors. Bariatric surgery is an effective treatment where less invasive management has been unsuccessful. The impact of socioeconomic deprivation on surgical outcomes is a novel area of research. The present study aims to investigate the effect of socioeconomic deprivation on bariatric surgery outcomes.

Data was prospectively collected at a regional bariatric centre in Scotland. The study included patients who received either a Roux-en-Y Gastric Bypass (RYGB) or Sleeve Gastrectomy (SG) (2008-2022). Follow-up occurred postoperatively at 6 months, 1 year and annually thereafter. Socioeconomic deprivation was measured using the Scottish Index of Multiple Deprivation (SIMD) using residential postcodes to generate a deprivation quintile (Q1-5). The primary outcome was percentage total weight loss (%TWL). Secondary outcomes included postoperative complications, comorbidity status, nutritional status, length of stay and re-admissions. Grouped analysis was conducted to represent a more deprived group (Q1-3) and a less deprived group (Q4-5). Statistical analysis was carried out of the data. The study was carried out using the STROBE principles.

316 patients were included (median follow-up, 7 years; median %TWL, 23.8%). There was no significant difference in median %TWL (p = 0.528), short-term (p = 0.619) or long-term (p = 0.164) complications and resolution (p = 0.472), improvement (p = 0.282) or exacerbation of comorbidities (p = 0.717) between socioeconomic quintiles.

Socioeconomic deprivation does not limit bariatric surgery outcomes and should not be a barrier to surgery.