Impact of Educational Status and Number of Children on Weight Loss Outcomes After Laparoscopic Sleeve Gastrectomy

Abstract

Objective: Laparoscopic sleeve gastrectomy (LSG) is a successful method to achieve sustained weight loss and reduce morbidity and mortality. However, outcomes vary widely based on several factors, including preoperative childbirth history and educational status. The purpose of this research is to evaluate the influence of the number of children and educational level before surgery on the weight reduction results in female patients who had LSG. Material and Method: We analyzed data from 70 female patients who underwent LSG between January 2017 and January 2022. Patients were stratified into groups based on the number of children (0 vs. ≥1) and educational status (primary or secondary school vs. high school or university). The primary outcome measures were the percentage of excess weight loss (%EWL) and percentage of total weight loss (%TWL) at 1-year post-surgery. Results: At 1 year, the mean %EWL was 79.3, and the mean %TWL was 36.2. No differences were observed in %EWL and %TWL between patients with and without children. However, patients with high school or university education had significantly better %EWL and %TWL outcomes compared to those with less education. Conclusion: Education level positively influences weight loss outcomes following LSG, while the number of children does not appear to significantly impact postoperative weight loss. These findings suggest that LSG can be equally effective in women regardless of their childbirth history, but higher education levels may contribute to better surgical outcomes.

Keywords

• educational status
• sleeve gastrectomy
• number of children
• weight loss

References

1. 1. Hirth DA, Jones EL, Rothchild KB, Mitchell BC, Schoen JA. Laparoscopic sleeve gastrectomy: Long-term weight loss outcomes. Surg Obes Relat Dis 2015;11(5):1004-1007.
2. 2. Dey A, Mittal T, Malik VK. Initial experience with laparoscopic sleeve gastrectomy by a novice bariatric team in an established bariatric center--a review of literature and initial results. Obes Surg 2013;23(4):541-547.
3. 3. Hecht LM, Hadwiger A, Martens K, Hamann A, Carlin AM, Miller-Matero LR. The association between the number of children and weight loss outcomes among individuals undergoing bariatric surgery. Surg Obes Relat Dis 2021;17(6):1127-1131.
4. 4. Mahoney ST, Strassle PD, Farrell TM, Duke MC. Does lower level of education and health literacy affect successful outcomes in bariatric surgery? J Laparoendosc Adv Surg Tech A 2019;29(8):1011-1015.
5. 5. Dilektasli E, Erol MF, Cayci HM, et al. Low Educational status and childhood obesity associated with ınsufficient mid-term weight loss after sleeve gastrectomy: A retrospective observational cohort study. Obes Surg 2017;27(1):162-168.
6. 6. Ochner CN, Jochner MC, Caruso EA, Teixeira J, Xavier Pi-Sunyer F. Effect of preoperative body mass index on weight loss after obesity surgery. Surg Obes Relat Dis 2013;9(3):423-427.
7. 7. Nikolić M, Kruljac I, Kirigin L, et al. Initial weight loss after restrictive bariatric procedures may predict mid-term weight maintenance: Results from a 12-month pilot trial. Bariatr Surg Pract Patient Care 2015;10(2):68-73.
8. 8. Berggren EK, Presley L, Amini SB, Hauguel-de Mouzon S, Catalano PM. Are the metabolic changes of pregnancy reversible in the first year postpartum? Diabetologia 2015;58(7):1561-1568.

9. 9. Hill B, Bergmeier H, McPhie S, et al. Is parity a risk factor for excessive weight gain during pregnancy and postpartum weight retention? A systematic review and meta-analysis. Obes Rev 2017;18(7):755-764.
10. 10. Chen JC, Jalilvand A, Wang V, et al. Influence of sociodemographic variables on weight loss outcomes up to 3 years following primary bariatric surgery. Surg Endosc 2021;35(10):5774-5786.
11. 11. Marín-León L, Oliveira HB, Barros MB, Dalgalarrondo P, Botega NJ. Social inequality and common mental disorders. Braz J Psychiatry 2007;29(3):250-253.
12. 12. Small L, Aplasca A. Child Obesity and mental health: A complex ınteraction. Child Adolesc Psychiatr Clin N Am 2016;25(2):269-282.
13. 13. Testa G, Granero R, Siragusa C, et al. Psychological predictors of poor weight loss following LSG: relevance of general psychopathology and impulsivity. Eat Weight Disord 2020;25(6):1621-1629.
14. 14. Pinto-Bastos A, de Lourdes M, Brandão I, Machado PPP, Conceição EM. Weight loss trajectories and psychobehavioral predictors of outcome of primary and reoperative bariatric surgery: A 2-year longitudinal study. Surg Obes Relat Dis 2019;15(7):1104-1112.
15. 15. Erdogdu UE, Cayci HM, Tardu A, Demirci H, Kisakol G, Guclu M. Health literacy and weight loss after bariatric surgery. Obes Surg 2019;29(12):3948-3953.
16. 16. Barcelo A, Valdivia A, Sabag A, et al. Educational differences in diabetes mortality among hispanics in the united states: an epidemiological analysis of vital statistics data (1989-2018). J Clin Med 2021;10(19):4498.