An obese Medicaid patient who undergoes Roux-en-Y gastric bypass surgery has a higher chance of getting back to work than an obese Medicaid patient who does not have the surgery, says an article in Archives of Surgery, October issue (theme issue).
The author explains that approximately 65% of adults in the United States are overweight, while 5% are morbidly obese; they have a BMI (body mass index) of over 40. “Obesity is associated with a variety of diseases, including diabetes mellitus, hypertension, hyperlipidemia, degenerative arthritis, sleep apnea and left ventricular hypertrophy. Depression, social isolation and discrimination further compound the disability associated with morbid obesity. As a result, morbid obesity results in dramatic increases in health care costs,” the authors say.
Amy J. Wagner, M.D., Virginia Mason Medical Center, Seattle, USA, and team looked at 38 medically disabled Medicaid patients; between 1997-2002 they underwent Roux-en-Y gastric bypass performed by the same surgeon. They were compared with 16 other Medicaid patients the same surgeon had seen, but did not undergo surgery. They collected the patients’ medical data by receiving their clinical charts and following up with telephone interviews (over the long-term).
The patients who were operated on had an average age of 48 years and a BMI (average) of 58 prior to surgery – they were followed up for 44 months. Those who did not undergo surgery were 51 years old on average and had a BMI of 54 at the beginning of the study – they were followed up for 32 months.
Those who received the surgery had a follow-up BMI of 36.2, while the non-operative patients had a follow-up BMI of 52.
“The patients who underwent Roux-en-Y gastric bypass were more likely to return to work, with 14 (37%) working, compared with 1 (6%) of the non-operative control patients. Return to work was more likely in patients who had resolution of comorbid conditions (co-occurring illnesses) after surgery,” the researchers said. Those who managed to get back to work were no longer in need of Medicaid funding.
The writers concluded “The practical implication of these findings is that the presence of reversible obesity-related comorbidities may be an appropriate prerequisite for approval of bariatric surgery in this population. Surgical treatment of morbid obesity has a profound effect on patients’ quality of life as evidenced by the sustained long-term weight loss, reversal of comorbidities, improved rating of quality of life and the patients’ ability to return to the workforce.”
“Return to Work After Gastric Bypass in Medicaid-Funded Morbidly Obese Patients”
Amy J. Wagner, MD; Joseph M. Fabry Jr, DO; Richard C. Thirlby, MD
Arch Surg. 2007;142:935-940.
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Written by: Christian Nordqvist