Metabolic disease severity after gastric bypass differs by sex, race, and ethnicity: trends using the Assessment of Obesity-related Metabolic Comorbidities scoring
In brief
Five years after gastric bypass, metabolic gains differed across racial and ethnic groups
In 351 patients at one US academic center, five-year patterns varied by condition: Hispanic/Latinx patients had sustained diabetes improvement, White patients had sustained improvement in cholesterol-related disease, and Black patients were the only group without significant hypertension improvement. Men had more severe hypertension before and after surgery but similar relative improvement to women; whether these differences reflect broader patient populations remains unclear.
- Journal
- Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery (Q1)
- Published
- 2 October 2026
- Study design
- Unclassified
- Evidence level
- Level 5, Expert Opinion (CEBM 5)
- Authors
- Tiffany L Wong, Annie Wang, John C Lew, Sandra L Taylor, Zainab Akinjobi, Shushmita M Ahmed, et al.
- PMID
- 42918674
- DOI
- 10.1016/j.soard.2026.09.013
Why clinicians should know about it
- Picked for Bariatric and Metabolic Surgery (paper of the day, 26 October 2026): Five-year RYGB metabolic outcomes across demographic groups
Abstract
BACKGROUND: The impact of race, insurance type, and sex on metabolic recovery after Roux-en-Y gastric bypass (RYGB) is incompletely understood. OBJECTIVES: Delineate how demographic factors influence metabolic outcomes after RYGB. SETTING: University Hospital, United States. METHODS: Assessment of Obesity-related Metabolic Comorbidities scores for type 2 diabetes (T2D), hypertension (HTN), and dyslipidemia (DYS) were determined for patients preoperatively and up to 5 years post-RYGB at a single academic institution. Generalized linear mixed-effect models were used to evaluate score trends and remission over time. RESULTS: Of 351 patients, 63% identified as non-Hispanic White (WNH), 13% as Black/African-American (B/AA), and 18% as Hispanic/Latinx (H/L). Most patients were female (76.6%) and privately insured (81.5%). H/L patients had more severe preoperative T2D than B/AA patients (P = .012), but differences resolved by 5 years, and only H/L patients showed sustained T2D improvement (P = .014). WNH patients had greater preoperative DYS severity than B/AA patients (P = .010) and were the only group with significant improvement at 5 years (P = .018). B/AA patients were the only group without significant HTN improvement by 5 years postoperatively. Private insurance was associated with long-term improvements in T2D and HLD. Although HTN was more severe in men than in women both preoperatively and postoperatively (P < .05), they experienced similar relative HTN improvement after surgery. Sustained improvement in total weight loss, T2D, and DYS severity was similar between sexes. CONCLUSIONS: Racial and ethnic discrepancies in long-term durability of metabolic improvement exist and differ by disease. Men are disproportionately underutilizing bariatric surgery and presenting with more severe HTN, which resulted in worse weight and HTN response to RYGB.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.