Bariatric metabolic surgery eliminates body mass index as a risk factor for unemployment


Setting

The effects of bariatric metabolic surgery (BMS) on health and comorbidities are well-known.
Socioeconomic factors have been increasingly in focus in recent investigations.

Objective

The aim of this study was to analyze the effects of BMS on predictive variables for
unemployment.

Methods

The study design was a retrospective cohort study including patients who underwent
BMS in one reference center for BMS. Patients treated between 2011 and 2017 were eligible
to participate in this study. Inclusion criteria were Roux-en-Y gastric bypass surgery,
follow-up of 60 months, and complete data on employment rate. Exclusion criteria were
secondary BMS, secondary referral, loss of follow-up, or patients aged 60 years and
above. Patients were stratified as employed independent of part-time work and as unemployed
if the patient had no current employment at the time of the visit. Follow-up visits
were performed after 6, 12, 24, 48, and 60 months.

Results

This study included 623 patients; prior to BMS, 239 (38.36%) patients were employed
and 384 (61.64%) unemployed. Risk factors for baseline unemployment included increased
body mass index (BMI) (OR 1.03, 95%CI 1.01 to 1.05, p = 0.010) and increased American
Society of Anesthesiology (ASA) score (OR 3.55, 95%CI 2.56 to 4.90, p < 0.001). Unemployment
rate dropped to 32.4% after 24 months (p < 0.001) and increased to 62.8% after 60
months. The BMI continuously decreased. Following BMS, the unemployment rate was no
longer associated with BMI (24 months: OR 0.97, 95%CI 0.95 to 1.01, p = 0.220; 60
months: 1.04, 95%CI 0.97 to 1.11, p = 0.269). The initial ASA status remained associated
with unemployment (OR 2.20, 95%CI 1.60 to 3.01, p < 0.001).

Conclusion

BMI showed some association with the unemployment rate prior to BMI. The unemployment
rate significantly decreased 24 months after BMS but increased to baseline values
after 60 months. Following BMS, BMI was no longer associated with unemployment.



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