The Effect of Bariatric Surgery On Employment Status and Mobility

Jean-Eric Tarride, BA, MA, PhD1, Ruth Breau, BA2, Dennis Hong, MD, MSc, FRCSC, FACS1, Scott Gmora, MD, FRCSC1, Mehran Anvari, MB, BS, PhD, FRCSC, FACS1. 1McMaster University, 2the Centre for Surgical Invention and Innovation

INTRODUCTION: A common perception exists that there is a higher rate of unemployment among morbidly obese patients. The question therefore arose as to whether bariatric surgery is beneficial to patients’ work and productivity. In addition, few studies have documented the impact of bariatric surgery on mobility. To better inform physicians, patients and decision makers, a sub-study of the Ontario Bariatric Registry was conducted to evaluate the impact of bariatric surgery on employment status and mobility.

Methods and procedures: To meet the objectives of the study, a survey was sent to all patients who underwent bariatric surgery at St Joseph Healthcare Hamilton, Ontario, Canada and who completed one year follow-up. Participants were invited to document their employment status at time of surgery and one year after surgery. In addition, patients documented any change in their employment status during the one-year time period prior to and after the surgery. Patients also completed the EQ-5D, a health-related quality of life questionnaire, to measure five domains including mobility. Statistical comparisons between time periods were conducted using t-tests for continuous variables and chi-squared tests for dichotomous variables.

Results: Out of 309 patients with one-year follow-up, 137 (44%) returned the questionnaire of whom 92% were female. Almost three-quarters of the participants were working full time (61%) or part time (13%) at time of surgery and 9% were on short (1%) or long-term (8%) disability. The remaining individuals were either retired (9%) or looking for work/working from home/attending school/other (8%). Overall, there were no major changes in employment status at one-year following bariatric surgery with 62% working full time, 15% working part time and 6% on disability. However more individuals reported a change in their employment status within one-year following surgery (26%) compared to one-year prior to the surgery (9%) (p=0.0003). Of these individuals who reported a change over the one-year following surgery, the majority started a new job (47%) or increased their work hours (32%). In terms of mobility, 70% of participants had slight (34%), moderate (29%) or severe problems (7%) walking at time of surgery compared to only 10% at 1 year following surgery (p<0.001). Similar statistically significant improvements were also seen in the other domains of the EQ-5D (e.g. self-care, usual activities, discomfort and anxiety/depression).

CONCLUSIONS: Bariatric surgery has a major impact on mobility. Alternative to common perception, many bariatric patients are working full time pre and post-surgery. More research is warranted to better understand if the changes in employment status following bariatric registry translate into better occupations and income.

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