Highlights
- •While living in close proximity to foods stores does not ensure utilization, in this study, patients who lived within a 10-Minute walk to food stores had better weight loss two years after bariatric surgery.
- •Black patients with access to more food stores within a 10-Minute walk and White patients with more access within a 5-Minute walk had greater %TWL over 24 months.
- •Living in areas with lower poverty levels did not negatively affect weight loss for Black patients.
- •There were no significant associations for weight loss based on unemployment rate or proximity to fitness/recreational facilities and percent open area.
Abstract
Background
While social determinants of health (SDoH) have gained attention for their role in
weight loss following bariatric surgery, electronic health record (EHR) data provide
limited information beyond demographics associated with disparities in weight loss.
Objective
To integrate EHR, census, and county data to explore disparities in SDoH and weight
loss among patients in the largest populous county of Ohio.
Setting
Seven hundred seventy-two patients (82.1% female; 37.0% Black) who had primary bariatric
surgery (48.7% gastric bypass) from 2015 to 2019 at Ohio State University.
Methods
EHR variables included race, insurance, procedure, and percent total weight lost (%TWL)
at 2/3, 6, 12, and 24 months. Census variables included poverty and unemployment rates.
County variables included food stores, fitness/recreational facilities, and open area
within a 5- and 10-minute walk from home. Two mixed multilevel models were conducted
with %TWL over 24 months, with visits as the between-subjects factor; race, census,
county, insurance, and procedure variables were covariates. Two additional sets of
models determined within-group differences for Black and White patients.
Results
Access to more food stores within a 10-minute walk was associated with greater %TWL
over 24 months (P = .029). Black patients with access to more food stores within a 10-minute (P = .017) and White patients with more access within a 5-minute walk (P = .015) had greater %TWL over 24 months. Black patients who lived in areas with higher
poverty rates (P = .036) experienced greater %TWL over 24 months. No significant differences were
found for unemployment rate or proximity to fitness/recreational facilities and open
areas.
Conclusions
Close proximity to food stores is associated with better weight loss 2 years after
bariatric surgery. Lower poverty levels did not negatively affect weight loss in Black
patients.
Keywords
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Article info
Publication history
Published online: December 29, 2022
Accepted:
December 17,
2022
Received:
August 13,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
Published by Elsevier Inc. on behalf of American Society for Metabolic and Bariatric Surgery.
