A. M. Williams1, S. E. Alfieri1, A. S. Kim1, A. F. Diab2, R. Mhaskar3, C. DuCoin2, J. A. Sujka2 3University Of South Florida College Of Medicine, Office Of Research, Tampa, FL, USA 1University Of South Florida College Of Medicine, Tampa, FL, USA 2University Of South Florida College Of Medicine, Department Of Surgery, Division Of Gastrointestinal Surgery, Tampa, FL, USA
Introduction:
Bariatric surgery outcomes are influenced by factors like age, sex, race, ethnicity, and socioeconomic status. Food insecurity (FI) is another potential factor affecting these outcomes. Limited research exists on the specific impact of FI on bariatric surgery outcomes. No prior studies have directly explored the relationship between residing in a high FI zip code and patient outcomes relating to weight loss post-surgery. We hypothesize that patients will have decreased weight loss post-surgery if they live in a high FI zip code.
Methods:
We conducted a retrospective study with 210 bariatric surgery patients at a tertiary referral center from January to December 2020. Patient weight and BMI were recorded at three time points: surgery date, one month postoperative, and 12 months postoperative. Residential addresses were collected, and FI rates for the corresponding Zip Code Tabulation Areas (ZCTA) were obtained from the 2022 Feeding America Map the Meal Gap study (2020 data).
Results:
The food insecurity rate showed a negative correlation of -18.3% (95% CI: -35% – -0.5%; p=0.039) with the percentage of excess weight loss (%EWL) at one year. In multivariate analysis, pre-operative BMI (p=0.001), presence of diabetes mellitus (p=0.008), and bariatric procedure type (p=0.000) were significant predictors of %EWL at one year. Even after adjusting for confounding factors, including sex, pre-operative BMI, insurance status, primary bariatric procedure, ASA classification, and emergency department visits, the increased food insecurity rate (p=0.047) remained significantly associated with decreased %EWL at one year.
Conclusion:
Residing in a high FI ZCTA correlated with decreased %EWL at one year after bariatric surgery. These findings highlight the importance of assessing FI status in pre-bariatric surgery patients and providing additional support to individuals facing food insecurity.
