Whites are twice as likely as blacks to have weight-loss surgery and people's views about how obesity affects their quality of life is an important factor in that difference, according to a new study.
The researchers interviewed 337 obese patients in the Boston area who were considered medically eligible for weight-loss surgery. The findings were published in the January issue of the Journal of General Internal Medicine.
"It's been assumed that the racial barrier to weight-loss surgery is economic, that people don't have insurance, are underinsured or can't afford the co-pay or the time off work, and that's why we don't see certain groups seeking treatment," study author Dr. Christina Wee, of Beth Israel Deaconess Medical Center, said in a center news release.
"But, in fact, the patients we talked to rarely mentioned economic barriers, so that didn't account for [the] twofold difference" between white patients and black patients, Wee noted.
Education levels and the impact of other health problems such as high blood pressure and diabetes also did not explain why whites were more likely than blacks to have weight-loss surgery, the investigators pointed out.
However, obesity-related quality-of-life issues -- such as mobility, sexual function, work life, self-esteem and social stigma -- did play a part in this racial disparity, the researchers said.
"What we found is that a significant reason that more African Americans have not considered weight-loss surgery is that obesity has not diminished their quality of life as much as it has diminished quality of life for Caucasians," Wee said in the news release.
The researchers also found that just as many blacks as whites said they would consider weight-loss surgery if their doctor recommended it, but doctors were less likely to recommend the surgery for black patients.
That may be because black patients are less likely to feel that obesity affects their quality of life, so they're less likely to express such concerns to their doctor, Wee explained.
"Quality of life is clearly a very important motivator to patients with obesity. And what this study shows is that those quality-of-life differences across race are so important that they may actually drive decision-making in a way that creates racial differences in how people think about undergoing treatment," she said.
"It speaks to the importance of thinking about the whole patient, factoring in personal values and facilitating individualized decision-making," Wee added.
The researchers also found that women are several times more likely than men to consider weight-loss surgery, and that doctors are less likely to recommend weight-loss surgery to men than women.
Nearly 100,000 Americans have weight-loss surgery every year.
