Racial Differences in Bariatric Surgical Approach: a Cross-Sectional National Inpatient Sample Analysis

William G. Wong, Rolfy A. Perez Holguin, Melissa Butt, Andrea Rigby, Ann M. Rogers, Chan Shen

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Purpose: Although racial inequalities in referral and access to bariatric surgical care have been well reported, racial difference in the selection of surgical techniques is understudied. This study examined factors associated with the utilization of the two main bariatric surgical techniques: laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB). Materials and Methods: The National Inpatient Sample database was queried for patients who underwent elective LSG or LRYGB for the treatment of severe obesity. Chi-square tests and multivariable logistic regression assessed associations of surgical approach with patient and facility characteristics. Sensitivity analyses examined the following body mass index (BMI) subgroups: < 40.0 kg/m2, 40.0–44.9 kg/m2, 45.0–49.9 kg/m2, and ≥ 50.0 kg/m2. Results: Within the final cohort (N = 86,053), 73.0% (N = 62,779) underwent LSG, and 27.0% (N = 23,274) underwent LRYGB. Patients with BMI 45.0–49.9 kg/m2 (OR = 0.85) and BMI ≥ 50.0 kg/m2 (OR = 0.80) were less likely to undergo LSG than patients with BMI 40.0–45.0 kg/m2 (all p < 0.001). However, Black (OR = 1.74) and White Hispanic patients (OR = 1.30) were more likely to undergo LSG than White non-Hispanic patients (all p < 0.005). In the BMI ≥ 50.0 kg/m2 group, Black patients were still more likely to undergo LSG compared to White non-Hispanic patients (OR = 1.69, p < 0.001), while Asians/Pacific Islanders were less likely to receive LSG than White non-Hispanic patients (OR = 0.41, p < 0.05). Conclusion: In this observational study, we identified racial differences in the selection of common bariatric surgical approaches across various BMI categories. Future investigations are warranted to study and to promote awareness of the racial/ethnic influence in attitudes on obesity, weight loss, financial support, and surgical risks during bariatric discussions with minorities. Graphical abstract: [Figure not available: see fulltext.].

Original languageEnglish (US)
Pages (from-to)3359-3367
Number of pages9
JournalObesity Surgery
Issue number10
StatePublished - Oct 2022

All Science Journal Classification (ASJC) codes

  • Surgery
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics


Dive into the research topics of 'Racial Differences in Bariatric Surgical Approach: a Cross-Sectional National Inpatient Sample Analysis'. Together they form a unique fingerprint.

Cite this