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Predictive factors

Race is an indicator of weight loss

African-American patients lost on average 10% less weight after gastric bypass than white patients in two studies
Type 2 diabetes is the "great equaliser" - leads African-American women to achieve similar excess weight loss to white women

Two studies presented at the recent ASMBS meeting in San Diego indicate that a patient’s race is a factor affecting weight loss following bariatric surgery.

In a the first study, researchers from the Einstein Healthcare Network in Philadelphia reported that African-Americans and males lost significant weight after gastric bypass surgery, but not as much as their white and female counterparts.

The study found African-Americans lost about 10% less of their excess weight than whites, while men of all races lost 10% less than women. Increasing age and higher initial weight were also identified as significant factors in predicting weight loss. The study examined 1,096 gastric bypass patients with at least one-year follow-up. Patients were on average 45 years old, and had an average BMI of 47.6.

“Further study is needed to determine what makes some groups more resistant to weight loss than others. It is likely there are many factors, from genetics to environment.” Dr Ramsey M Dallal, study lead

Excess weight loss was 63.2% in African-American patients and 71.9% in white patients, and 63% in males compared to 71% in females. Resolution or improvement of obesity-related conditions, including type 2 diabetes, hypertension and sleep apnea, were similar across all groups.

“The improvements in health status are consistent among all groups, however, for some reason, weight loss itself is variable,” said Dr Ramsey M Dallal, chief of bariatric/minimally invasive surgery at Einstein Healthcare Network.

“Further study is needed to determine what makes some groups more resistant to weight loss than others. It is likely there are many factors, from genetics to environment.”

In the second study, by investigators from Duke University, African-American women lost about 10% less of their excess weight after gastric bypass than their Caucasian counterparts, but if type 2 diabetes was present, weight loss and the rate of diabetes remission was about the same,.

The researchers said that while race may have been a factor in weight loss, it did not play a role in surgery’s effect on type 2 diabetes and in weight loss among people with type 2 diabetes. Both African-American and Caucasian women experienced similar diabetes remission rates (75% and 77%, respectively).

 “For some reason, diabetes was the great equaliser when it came to weight loss” Dr Alfonso Torquati, study co-author

Larger differences occurred in excess weight loss among women who did not have diabetes. African-American women on average lost 56.7% of their excess weight over three years, while Caucasian women lost 64.7%. However, if diabetes was present, the weight loss gap narrowed. African-American women with diabetes lost on average 59.8% of their excess weight.

 “For some reason, diabetes was the great equaliser when it came to weight loss,” said Dr Alfonso Torquati, Duke University, co-author of the study. "African-American women with Type 2 diabetes lost a similar amount of excess weight as Caucasian women. Racial differences in excess weight loss only emerged between non-diabetic women. Further study is needed to determine if the reasons are genetic or because of differences in body fat distribution or both.”

The 282-patient study compared the outcomes of African-American women to Caucasian women matched for initial BMI, age and health status. On average, women were 40 years old and had a BMI of 50. About 20% of the patients had type 2 diabetes. Nearly 70% of African-Americans had hypertension, compared with 50% of Caucasians, and about one third of both groups had sleep apnea.

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