By Alan Mozes Health Day Journalist
MONDAY, June 14, 2021 (HealthDay News) – The South and Midwest have the highest obesity rates in the country, but new study finds severely obese residents of these areas least likely to choose weight loss vital. surgery.
âBariatric surgery has been shown to provide long-term weight loss, lasting improvements in cardiovascular and metabolic health, and even prolonged longevity,â noted study author Dr. Scott Schimpke, but the analysis âshows that we continue to underuse the best treatment for morbid diseases. obesity and associated metabolic syndrome. “
Schimpke, assistant professor in the division of minimally invasive and bariatric surgery at Rush Medical College in Chicago, and colleagues point out that obesity is linked to a significantly higher risk of developing more than 40 different serious diseases, including heart disease. and diabetes.
The American Heart Association explains that metabolic syndrome – a grouping of five different conditions – increases the risk of such diseases. Abdominal obesity is one such condition; the other four include high blood sugar, high triglycerides, high blood pressure, and low levels of “good” HDL cholesterol.
Bariatric surgery – including sleeve gastrectomy and gastric bypass – offers an opportunity to reduce this risk by helping patients achieve significant weight loss, investigators said.
In fact, the study team noted that bariatric surgery is the standard of care for severely obese patients. Severe obesity is defined as having a body mass index (BMI) of 40, or a BMI of 35 and above, as well as obesity-related complications such as diabetes.
Using data from insurance claims, Schimpke and his team focused on a group of nearly 1.8 million patients in the United States who were severely obese – and therefore eligible for weight loss surgery – during the decade starting in 2010.
Of these, approximately 100,000 actually underwent weight loss surgery during this period. But procedural models varied considerably from state to state.
For example, while about 9% to 10.4% of eligible patients in New Jersey, Rhode Island, and Delaware opted for surgery, less than 3% did so in West Virginia, Alabama, and in Arkansas.
Overall, the researchers determined that the lowest membership rate by region was the Midwest, where just over 4% of eligible patients underwent surgery, despite the fact that nearly 34% of residents of the Midwest are obese (which makes the region home to the obesity rate in the country).
In contrast, the highest rate of opt-in surgery (nearly 8%) was observed in the Northeast region, where the overall obesity rate is lower (29%).
The results were presented last week at a virtual meeting of the American Society for Metabolic and Bariatric Surgery. Such research is considered preliminary until it is published in a peer-reviewed journal.
âThere are probably several factors that contribute to the great variation in use,â said Schimpke. He highlighted the differences in: levels of access to medical care; beliefs and attitudes among patients and treating physicians; number of hospitals and surgeons available; and insurance coverage requirements.
Schimpke also highlighted the “negative psychosocial connotation associated with bariatric surgery among physicians / practitioners and patients, which needs to be addressed through strategic campaigns detailing the safety and efficacy of bariatric surgery”.
Ultimately, there’s likely a wide range of social, cultural, and economic factors at play, suggested Lona Sandon, program director in the department of clinical nutrition at the School of Health Professions at UT Southwestern Medical Center in Dallas. She was not part of the research.
On the one hand, “people who are surrounded by other people of similar height may not perceive their weight to be outside the norm and therefore not seek weight loss surgery,” said Sandon. “[And] there are differences in ethnicity and culture between states with the highest obesity rates compared to states with lower rates. “
Additionally, “states with higher obesity rates also tend to have higher rates of food insecurity, which means lower incomes in general,” she noted. “Weight loss surgery is an expensive proposition, especially if you don’t have good insurance coverage for it.”
But even though the success of weight loss depends on making a “difficult” change in diet and lifestyle postoperatively, the process can certainly “help people lose weight and become co-morbid.” [other negative health] conditions under better control, âsaid Sandon.
It is therefore important, she said, to help eligible patients better “understand treatment options and the potential for success,” by sharing the successes of the surgery and highlighting the benefits of reducing problems. high-risk health conditions such as blood pressure and diabetes.
SOURCES: Scott Schimpke, MD, assistant professor, Division of Minimally Invasive and Bariatric Surgery, Rush Medical College, Chicago; Lona Sandon, PhD, RDN, LD, Program Director and Associate Professor, Department of Clinical Nutrition, School of Health Professions, UT Southwestern Medical Center, Dallas; American Society for Metabolic and Bariatric Surgery, presentation, virtual annual meeting, June 10-12, 2021
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