Evaluating outcomes after metabolic/bariatric surgery among middle Eastern and North African patients in Michigan.

Abstract

Background: The Middle Eastern and North African (MENA) population of the United States consists of 3.8 million citizens. This study compares health care outcomes for MENA patients undergoing metabolic and bariatric surgery (MBS) in Michigan to those of non-MENA patients statewide.

Objectives: To compare outcomes of MBS between MENA and non-MENA patients in Michigan and identify disparities in surgery rates.

Setting: Michigan Bariatric Surgery Collaborative (MBSC), Ann Arbor, MI.

Methods: This retrospective cohort study used data from the MBSC database from 2017 to 2024. The cohort consisted of self-identified MENA patients (n = 799), approximately 1.5% of the MBSC total patient cohort. Data collected included demographic information, co-morbidities, type of bariatric procedure performed, adverse events at 30 days and at 1-year postoperative, including weight loss and changes in co-morbid status.

Results: Compared to non-MENA patients, MENA patients were more likely to be males (25.8% vs. 18.5%; P < .0001), present at younger ages (age < 30 years: 21.8% vs. 11.0%, P < .0001), have lower initial body mass index (BMI) (45.1 vs 47.4, P < .001), be active smokers (12.6% vs 8.5%; P < .0001), and undergo sleeve gastrectomy (84.7% vs 80.1%; P = .0011). There were no differences in 30-day complications (5.9% vs. 5.7%, P = .5056), although MENA patients had lower rates of emergency department visits (6.3% vs 7.1%, P = .0139) and healthcare utilization (8.6% vs 10.0%, P = .0117). Overall, there were no differences in weight loss outcomes or rates of comorbidity improvement at 1 year following MBS among MENA patients undergoing gastric bypass specifically, the percent total weight loss at 1 year was lower than non-MENA patients (30.2% vs 33.4%, P = .0168).

Conclusion: MENA individuals tend to pursue MBS at a younger age and with a lower BMI. Bariatric surgery appears equally safe and similarly effective in this patient population.