Impact of bariatric surgery on monthly earnings and employment: a national linked data study in England, 2014-2022

There is evidence that living with obesity can affect an individual's pay and employment, but there is little evidence on the impact of weight-management interventions in improving labour market outcomes of individuals. We evaluate the impact of bariatric surgery on monthly earnings and employee status among working-age adults, and examine variations across sociodemographic characteristics.

This population-based, retrospective longitudinal cohort study for England included 40,662 individuals who had a bariatric surgery procedure and obesity diagnosis between 1 April 2014 and 31 December 2022, with no bariatric surgery history in the previous 5 years, and were 25 to 64 years old at the date of surgery. 49,921 individuals sampled from the general population who had not had bariatric surgery were also included, matched by age and sex. The main outcome measures were monthly employee pay-for all months and only months where the individual was in paid employment-expressed in 2023 prices and paid employee status.

Among people living with obesity who had bariatric surgery, there was a sustained increase in monthly employee pay from 6 months after surgery with a mean increase of £84 per month (95% confidence interval [Cl]: 63-106) 5 years after surgery compared with the 6 months before surgery. There was a sustained increase in the probability of being a paid employee from 4 months after bariatric surgery, with a mean increase of 4.3 percentage points (95% Cl: 3.7-4.9) 5 years after surgery.

Bariatric surgery is associated with an increased probability of being employed, resulting in increased earnings. This suggests that living with obesity negatively impacts labour market outcomes and that obesity management interventions are likely to generate economic benefits both to individuals and on a macroeconomic level by increasing the likelihood of employment of people living with obesity.