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Women's Health Education Program Scholars' Projects

Gender Differences in Bariatric Surgery: Patient Characteristics, Outcomes, and Considerations

WHEP Scholar Tristan Seton

WHEP Scholar Tristan Seton
Drexel University College of Medicine, Class of 2021

Bariatric surgery is an effective weight loss procedure that has become increasingly common in the past 20 years, but it is unfortunately still underutilized across genders. Because this procedure is related to body weight, its efficacy and outcomes are also inherently connected to patient behavior. Gender is strongly related to weight and it is therefore essential to consider in examining patient behavior in the context of weight loss surgery.

While men and women have similar obesity rates, their perceptions of weight, preferred weight loss methods, and physical and mental health comorbidities differ. Women are more likely than men to accurately perceive their own obesity and attempt weight loss, but are also less likely to succeed. Women are also more likely to undergo bariatric surgery, and while this is beneficial to reducing obesity, the motivations and social factors behind seeking weight loss surgery should be understood. Post-operatively, women have worse surgery satisfaction, body image scores, and lower depression scores than men, so managing patient expectations and understanding the body image standards society places on women are important in psychological outcomes. Society’s double standard of body image for men and women should be understood when treating obese patients as it likely influences underutilization in men and psychological outcomes in women.

Women have better physical health outcomes and weight loss, lower complications (including thrombotic and cardiovascular events) and better postoperative follow-up than male patients undergoing surgery. This knowledge should encourage eligible women considering weight loss surgery, and should also inform male patients and their physicians about the potential risks and importance of follow up. Overall, bariatric surgery can effectively treat obesity and improve the medical comorbidities associated with it regardless of gender, but the effect of gender on obesity should be considered as it does impact patient care. Further areas of study regarding gender and obesity include the effects of estrogen on receptors associated with fat processing and the positive effects of bariatric surgery on female fertility and sexual health.

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