Obese men face risks when they delay bariatric surgery

Obese women are four times more likely than men to seek weight-loss surgery. When they do, male patients tend to be older, more obese, and sicker than women.

“It is important for men to realize that obesity poses a serious threat to their health and lifespan,” says Mohamed Ali, senior author of the study and chief of bariatric surgery at the University of California, Davis. “A patient who is 100 pounds or more above his ideal body weight poses a therapeutic dilemma and should be referred to a surgeon.”

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For the study, published in Surgical Endoscopy, Ali and his colleagues collected information from 1,368 patients who were evaluated for bariatric surgery at UC Davis between 2002 and 2006. A vast majority of them—nearly 82 percent—were female.

Both men and women in the study were likely to be affected by weight-related conditions such as hypertension, diabetes, obstructive sleep apnea, elevated cholesterol and fat levels in the blood, gastroesophageal reflux disease, musculoskeletal peripheral disease, back pain, depression and metabolic syndrome, a combination of conditions that increases the risk of cardiovascular disease.

There were some distinctions, however, between men and women in the study. The male participants:

• Had more weight-related health conditions as well as more serious forms of those conditions (an average of 4.54 conditions and 3.7 serious conditions for men, compared to an average of 4.15 conditions and 3.08 serious conditions for women)
• Were more likely to have hypertension (68.8 percent versus 55.3 percent), diabetes (36.4 percent versus 28.9 percent), obstructive sleep apnea (71.9 percent versus 45.7 percent) and metabolic syndrome (20.9 percent versus 15.2 percent)
• Had higher body mass index (BMI) measures (an average of 48.7 BMI for males compared to 46.6 BMI for females) and were more likely to have class IV obesity, which is a BMI between 50 and 59
• Were about two years older than the females and more likely to be over 50 years of age

Even though the weight, health, quality of life, psychosocial function, and lifespan of an obese male could be dramatically improved by surgical weight loss, Ali says that he and other bariatric surgeons must balance these potential benefits against the patient’s risk for post-surgical complications.

“This risk would be significantly lessened if obese males were referred to bariatric surgeons before they develop serious disease complications,” says Ali, whose study is believed to be the first in the US to investigate gender-specific health disparities in patients seeking weight-loss surgery.

At the time of Ali’s analysis, 930 patients (70 percent) included in the study had undergone bariatric surgery, but only 14.4 percent of them were men.

The Foundation for Surgical Fellowships helped support the study.