White Americans who are obese are twice as likely as black Americans to have surgery to tackle the problem, a study has found.
Bariatric surgery is now recognised as a successful treatment for preventing serious complications of obesity such as diabetes and high blood pressure. The new study is one of the first to look at whether people who need surgery most are actually receiving it.
Researchers at the Medical University of South Carolina and Imperial College London studied rates of bariatric surgery in the US from 1999 to 2010.
Twenty-two per cent of black women and 11 per cent of black men were eligible for bariatric surgery, compared with 12 per cent of white women and eight per cent of white men. But twice as many eligible white women and men than black women and men received bariatric surgery.
Differences in insurance coverage appeared to be partly responsible for the discrepancy: about 70 per cent of eligible white men and women had private health insurance compared with 50 per cent of black men and women.
"Bariatric surgery has been shown to be an effective treatment for moderate to clinically severe obesity and more importantly is has the benefit of successfully resolving or improving the important chronic conditions of diabetes and hypertension in the majority of cases," said Arch G. Mainous III, from the Medical University of South Carolina.
"Bariatric surgery can improve quality of life, decrease the risk of premature death, and lower disability and health-care costs. Consequently, this health disparity in treatment has implications for health care costs and morbidity due to common diseases like diabetes and hypertension, conditions that are highly prevalent in the African American community."
Dr Sonia Saxena, from the School of Public Health at Imperial College London, said: "Our earlier research found that 45 per cent of overweight patients who regularly visited the doctor's office did not recall being told by their doctor that they had a weight problem. Those who did were six to eight times more likely to recognise the problem and twice as likely to do something about it.
"Our new findings suggest that differences in insurance coverage are part of the reason why black Americans are less likely to have bariatric surgery, but it may not be the whole story. We need more research to look at whether cultural differences, perhaps a greater acceptance of obesity, lack of awareness of the risks or mistrust of doctors, might also be contributing." Around half of black men and women in the US are obese, compared with one third of white adults. The study found that around six out of every thousand eligible white women had bariatric surgery compared with three out of every thousand eligible black women. Two out of every thousand eligible white men had bariatric surgery compared with one out of every thousand eligible black men.
The findings are published in the American Journal of Gastroenterology.
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