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Gender and surgery

Men delay surgery, leads to greater problems

Women likely than men to seek bariatric surgery

Women are more likely to seek bariatric surgery compared with their male counterparts, according to researchers from the University of California. In addition, by the time men do consult their doctor about surgery, they are older, more obese and sicker than women claims the study published in the journal Surgical Endoscopy.

"It is important for men to realise that obesity poses a serious threat to their health and life spans," said senior study author Dr Mohamed Ali, chief of bariatric surgery at the University of California. "A patient who is 100lbs or more above his ideal body weight poses a therapeutic dilemma and should be referred to a surgeon."

For the study, the researchers examined data from nearly 1,400 patients who were evaluated for weight-loss surgery at UC Davis between 2002 and 2006. Nearly 82 percent of the patients were women.

The male patients had more obesity-related health problems than women (an average of 4.5 versus 4.2) and more serious forms of these conditions.

For example, men were more likely to have high blood pressure (69 percent vs. 55 percent), diabetes (36 percent vs. 29 percent) and obstructive sleep apnoea (72 percent vs. 46 percent). Metabolic syndrome was also more common among males (21 percent vs 15 percent).

Men also presented with higher BMI, nearly 49, while women's BMI averaged less than 47. In addition, male patients were about two years older than female patients and more likely to be over age 50.

At the time the researchers conducted their analysis, 70 percent of the patients in the study had undergone weight-loss surgery, but only 14 percent of them were men.

The paper concludes: “Although men typically comprise less than 20% of bariatric surgery patients, they potentially have more to gain from these operations. Men present later in life, with more advanced obesity, and with more complicated comorbidities. Such findings mandate more research and resources to investigate this barrier to treatment and to provide the morbidly obese male with the surgical care he clearly needs.”

Even though the weight, health, quality of life, psychosocial function, and lifespan of an obese male could be dramatically improved by surgical weight loss, Ali says that he and other bariatric surgeons must balance these potential benefits against the patient’s risk for post-surgical complications.

“This risk would be significantly lessened if obese males were referred to bariatric surgeons before they develop serious disease complications,” he added Ali, whose study is believed to be the first in the US to investigate gender-specific health disparities in patients seeking weight-loss surgery.

Ali said that although weight-loss surgery can help obese men, surgeons must weigh the potential benefits against a patient's risk for post-surgical complications.

"This risk would be significantly lessened if obese males were referred to [weight-loss] surgeons before they develop serious disease complications," he concluded.

The Foundation for Surgical Fellowships helped support the study.

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