Disparities in the impact of access to and outcomes of bariatric surgery among different ethnoracial and socioeconomic populations: a narrative review of the literature

Background and Objective: Obesity and its associated chronic medical conditions such as diabetes and hypertension are among the leading health concerns in the developed world. Bariatric and metabolic surgery has emerged as an established and definitive treatment for severe obesity. Given the disproportionate burden of obesity and diabetes on different racial and socioeconomic populations, studies have assessed the impact of these disparities in bariatric surgery patients.Methods: A comprehensive search of the current literature utilizing the following keywords was performed: bariatric surgery and a combination of disparities, outcomes, complications, mortality, access to care or socioeconomic factors.Key Content and Findings: We review the impact of ethnoracial differences on access to care and outcomes of bariatric surgery including weight loss, comorbidity remission, complications and mortality. Existing literature demonstrates reduced weight loss and higher complication rates in non-Hispanic Black patients compared to White patients with trends toward normalization of weight loss variation and comorbidity remission among ethnic groups over longer follow up times.Conclusions: Bariatric surgeons should consider ethnoracial and socioeconomic when counseling patients regarding bariatric surgery to support patients at risk of poorer outcomes. Further prospective research is needed to examine impact of ethnoracial and socioeconomic disparities on bariatric surgery patients.