Obese often return to full-time work after surgery
After undergoing gastric bypass surgery to treat extreme obesity, also known as “morbid” obesity, roughly one third of patients who were medically disabled and on Medicaid can return to full-time work, according to a report in the Archives of Surgery. The likelihood appears to be greatest among patients with obesity-related conditions that resolve after treatment.
Gastric bypass surgery, also referred to as bariatric surgery, “is the only effective treatment for morbid obesity,” according to Dr. Richard C. Thirlby and associates at the Virginia Mason Medical Center in Seattle.
The team reviewed the records of these patients, who had been seen between 1997 and 2002 and followed for about 3 years. Outcomes for the 38 patients who had undergone gastric bypass were compared with those of 16 patients who had no surgery.
The average body mass index (BMI), the ratio of height to weight, was 58 in the surgical group and 54 in the comparison group. BMIs that are considered to be normal range from 18.5 to 24.9, with a score of 30 or higher considered obese.
The number of other medical conditions averaged 4.0 and 3.1, respectively.
During follow-up, 14 (37 percent) patients in the surgery group had returned to work, versus one (6 percent) in the comparison group.
The final BMI averaged 36 in the surgery group and 52 in the control group.
The number of coexisting illnesses increased in the comparison group and decreased in the surgery group. Conditions affected the most were gastroesophageal reflux disease, also referred to as “GERD,” sleep apnea, and diabetes. The investigators found that patients who had a greater than average reduction in the number of co-existing conditions were more likely to return to the workforce (12 of 14, 86 percent).
The investigators noted that the total amount of weight lost, or final BMI, in the surgery group was not the factor associated with re-employment.
The reduction in obesity-related conditions was more “reliable than the amount of weight lost as a predictor of patients’ ability to return to work,” Thirlby and his associates conclude.
The investigators note, however, that patients with more than six preoperative illnesses did not return to work, implying that these patients are “perhaps too severely disabled to benefit from rehabilitation.”
SOURCE: Archives of Surgery, October 2007.
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