Comment on: Racial Disparities in Perioperative Outcomes After Bariatric Surgery

Zhamak Khorgami, Nestor de la Cruz-Muñoz

Volume 15, Issue 5 Surgery for Obesity and Related Diseases (SOARD)

Key Takeaways

Research shows patients from different racial/ethnic backgrounds can experience different complication rates and outcomes after bariatric surgery. This commentary discusses contributing factors and solutions.
Dr. de la Cruz-Muñoz's landmark ethnicity study became the 5th most cited article in Obesity Surgery's history, with extensive additional research on disparities.
Being invited to write this SOARD commentary reflects standing as a national voice on health equity in bariatric surgery.
For diverse patients, this reinforces a career-long commitment to equitable surgical outcomes across all groups.

Abstract/Summary

This invited commentary published in SOARD provided expert analysis on a study examining racial disparities in perioperative outcomes after bariatric surgery, addressing socioeconomic factors, access to care, implicit bias, and biological variability contributing to outcome differences across racial groups, drawing on extensive prior research on ethnicity and bariatric surgery outcomes.

In-Depth Review

The Study Being Discussed

In 2019, national MBSAQIP study by Sheka and colleagues analyzed 108,198 patients in the national MBSAQIP registry who had gastric bypass or sleeve gastrectomy. Black patients arrived at surgery with a higher BMI and more obesity-related disease than non-Hispanic White patients, and they had worse short-term outcomes, including higher mortality after sleeve gastrectomy. The editors of Surgery for Obesity and Related Diseases invited Dr. Zhamak Khorgami and Dr. de la Cruz-Muñoz to comment.

What the Commentary Addresses

The commentary places these findings in the context of earlier research on ethnicity and bariatric outcomes, including our own study of 3,268 Miami patients, and discusses the factors that may contribute to different outcomes between racial groups:

Socioeconomic factors and access to care, including delayed referral that leads patients to surgery sicker and heavier.
Implicit bias and differences in the care patients receive.
Biological variability that may affect how patients respond to surgery.

What This Means for Patients

Bariatric surgery is safe and effective for patients of every background, but national data show that Black patients often reach surgery later and with more advanced disease. Earlier referral, careful preparation and strong follow-up help close that gap. Read Is Bariatric Surgery Safe? and our guide on how to choose a bariatric surgeon.

Expert Commentary

Disparities in outcomes are not inevitable. In Miami, where most of my patients are Hispanic or Black, we have seen that patients of every background can do very well. When outcomes differ, we have to look at access, timing and the support patients receive after surgery, not just at the operation itself.

— Dr. Nestor de la Cruz-Muñoz

Related Research

Khorgami Z, De La Cruz-Muñoz N. Comment on: Racial Disparities in Perioperative Outcomes After Bariatric Surgery. Surgery for Obesity and Related Diseases. 2019;15(5):804-805. doi:10.1016/j.soard.2019.02.008.