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Researchers: Bariatric Surgery Screening Should Include Sexual Orientation

— LGBT status may predict lower rates of post-surgical follow-up

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NATIONAL HARBOR, Maryland -- In order to provide more tailored care for patients under consideration for bariatric surgery, researchers said here, clinicians should ask about patients' sexual orientation.

LGBT individuals constitute an estimated 5%-10% in the U.S. population, yet only about 0.3% of bariatric patients were identified in a large single-center database as having a same-sex partner, according to lead investigator Nova Szoka, MD, of West Virginia University in Morgantown, and colleagues.

Moreover, 31% of those LGBT patients were lost to follow-up, the researchers found.

Findings from the pilot study were presented at the .

They're important, said presenter Spring Lepak, MA, also of West Virginia University, during an oral presentation of the findings, because LGBT status appears to be related to weight issues and may affect post-surgical outcomes.

"We know that lesbian and bisexual women are twice as likely to be obese as straight women," said Lepak. And, "in adolescence, gay men are more likely to struggle with body weight issues, and this can at times, lead to development of eating disorders."

"The idea is that in order to improve the patient-provider rapport, we need to be able to identify these patients and to be culturally competent and know who it is we're helping, and what the specific needs are for this population," Lepak concluded.

"As a result of this, we were able to modify our intake forms," she added, highlighting it is important to separate sexual orientation and gender identify on bariatric surgery intake forms.

The researchers retrospectively reviewed 10-year data from the Duke Center for Metabolic and Weight Loss Surgery database.

A total of 5,576 patients' medical records were reviewed, of which 81% were women, to determine self-reported partner status during the psychological evaluation prior to metabolic surgery.

In fact, for very few in the database was the presence of a partner identified at all -- 145 in total. Of these individuals, most did not indicate the sex of the partner; 42 reported having an opposite-sex partner and 16 a same-sex partner.

Among the LGBT partner patients, the average weight prior to surgery was 305 lbs and a BMI of 48.5, which was similar to the non-LGBT cohort. At one year after surgery, average weight was 200 lbs and BMI 30.

But that excluded the 31% of LGBT-identified individuals (n=5) lost to follow-up. Said Szoka, "I think if people don't feel comfortable with their physician, if they are not 'out', that may hinder long-term follow-up."

The study was ultimately limited to the small sample size and that sexual orientation was identified only for partnered individuals.

  • author['full_name']

    Kristen Monaco is a senior staff writer, focusing on endocrinology, psychiatry, and nephrology news. Based out of the New York City office, she’s worked at the company since 2015.

Disclosures

No funding information was provided. Szoka and Lepak reported no relevant disclosures.

Primary Source

ObesityWeek 2017

Szoka N, et al "Lesbian, gay, bisexual, transgender (LGBT) bariatric patients: An unseen population" ObesityWeek 2017; Abstract A308.