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Does bariatric surgery improve occupational outcomes?
Bariatric surgery improve occupational outcomes by reducing levels of unemployment and absenteeism, according to researchers from the University Hospitals of North Midlands, Stoke on Trent, Staffordshire, UK. However, in their literature review, they caution that the evidence is limited and further studies are needed before any conclusions can be made on the wider economic, social and psychological benefits of bariatric surgery.
In the study, ‘Systematic Review and Meta-Analysis of Occupational Outcomes after Bariatric Surgery’, published in Obesity Surgery, the authors performed a systematic review and meta-analysis of the literature to assess the impact of bariatric surgery on occupational outcomes. From an initial search that produced 189 results, only ten studies met their inclusion criteria with data on 2,085 patients. Unsurprisingly, the majority of the patients were female, the median age ranged from 32.4 to 48 years and the mean preoperative BMI ranged from 41.6 to 58.3.
Only seven studies recorded the percentage of patients in employment preoperatively and postoperatively, and only one reported a statistically significant increase in employment in the postoperative period. Overall, the meta-analysis did not suggest a significant improve in overall employment rates after surgery (p=0.155). With regard to unemployed patients, the pooled analysis showed only 26.4% of unemployed patients returned to work after bariatric surgery.
However, in studies that compared unemployed, obese patients undergoing bariatric surgery with unemployed, obese, non-surgical patients – surgical patients were 3.24 times more likely to return to work than the non-surgical counterparts.
Three studies show that surgery reduced absenteeism via annual sick days from 56 to 28 days (p=0.02), from 33 to 1 day (no p value presented) and from 12.5 to 6.3 days (p<0.05), with a single study reporting that the percentage of patients taking no sick days within a year rose from 25 to 41%. One study that examined disability benefits claims reported a significant reduction of patients claiming benefits pre-operatively and after surgery (32.2% vs.10.2%).
“There is limited evidence in the literature regarding the occupational outcomes following bariatric surgery, and further studies are required before firm conclusions can be drawn,” they conclude. “However, the existing evidence does suggest that bariatric surgery has a generally positive impact on occupational outcomes. This suggests that surgery may have wider economic, social and psychological benefits above and beyond its immediate health benefits.”