Racial Disparities in Minor Complications After Bariatric Surgery

A recent study presented at the American Society for Metabolic and Bariatric Surgery (ASMBS) 2025 Annual Scientific Meeting highlights a concerning trend: Black patients are more likely to face minor complications after metabolic and bariatric surgery compared to their White counterparts. Researchers from the Yale School of Medicine analyzed data from over 1.1 million patients who underwent primary laparoscopic sleeve gastrectomy (LSG) or Roux-en-Y gastric bypass (RYGB) procedures between 2016 and 2023. The findings revealed that the incidence of minor complications, including dehydration and infections, increased significantly among Black patients, rising from 10.2% in 2016 to 15% in 2023, while for White patients, the rate increased from 7.6% to 12.1%.

According to Dr. Safraz Hamid, a co-author of the study and a physician at Yale School of Medicine, "We were surprised the minor complication rate increased year after year and that racial disparities persisted. More work is needed to identify what's causing the uptick and how it can be reversed. A focus on enhanced discharge education and an action plan surrounding postoperative hydration may be beneficial." The study analyzed data from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database, which included a diverse patient population (75% White and 25% Black patients).

Notably, while the rates of serious complications and mortality remained low (0.4% and 0.1% respectively), the disparity in minor complications raises significant questions about post-operative care and patient education practices. Dr. Ann M. Rogers, the President of ASMBS, emphasized the importance of understanding these trends. She stated, "This study underscores the safety of metabolic and bariatric surgery but also suggests a need to focus more attention on identifying patients at higher risk for minor complications so that we can take measures to prevent them."

Obesity, which affects approximately 40.3% of adults in the United States according to the Centers for Disease Control and Prevention (CDC), is a significant risk factor for various health complications. Experts assert that the increase in complications among Black patients may be linked to systemic healthcare disparities that necessitate targeted interventions.

In summary, this emerging evidence indicates that while bariatric surgeries are generally safe, there remains a critical need to address racial disparities in postoperative outcomes. Further research is required to understand the underlying causes of these disparities and to implement effective solutions that can enhance the quality of care for all patients undergoing these significant surgical procedures.