The impact of socioeconomic factors on patient preparation for bariatric surgery

Background: Socioeconomic factors (SEF) influence bariatric surgery access and outcomes perhaps because of variations in patient knowledge and behaviors. This study examines the associations between income, formal education, race, health insurance, employment status, and patient self-educational and behavioral activities prior to bariatric surgery. Methods: From March 2005 through January 2006, we surveyed 127 individuals who contacted our office seeking bariatric surgery. Study participants were asked to report their income, formal education, health insurance, employment status, height, weight, and standard demographic data. The type and number of self-educational resources utilized were elicited; a description of current eating and exercise behaviors was obtained; and an objective assessment (OA) of knowledge of the risks of both obesity and bariatric procedures was completed. Results: The most valuable self-educational resource cited by respondents was the internet (41.2%) and was unaffected by SEF. Individuals who were employed, privately insured, white, and earning ≥$20,000/year reported using a greater number of self-educational resources than their peers, while subjects who were privately insured, had higher formal educational levels, and earned ≥$20,000/year demonstrated greater proficiency on the OA instrument. Engagement in healthy eating and exercise behaviors was unaffected by any SEF. On multivariate analysis, higher income was the sole significant factor directly related to the number of educational resources utilized and proficiency on OA. Conclusion: Obese patients from lower-income households may benefit from additional preoperative education. All individuals, regardless of socioeconomic factors, must be encouraged to implement healthy eating and exercise behaviors preoperatively.