The study is titled: ”Excess weight loss and cardio-metabolic parameter reduction diminished among Hispanics undergoing bariatric surgery: Outcomes in more than 2000 consecutive Hispanic patients at a single institution”. It was published in the journal of The American College of Surgeons, JACS, in this month issue.

2002 Hispanic patients underwent bariatric surgery from 2008 till 2014 including 1235 gastric bypass, 600 gastric sleeve and 167 gastric band surgeries. This is the largest series published so far for Hispanic patients undergoing weight loss surgery. Hispanic adults are twice more likely to have diabetes and suffer more serious complications than non-Hispanic whites. Hispanics have a higher incidence of end stage renal disease when compared to Caucasians and have demonstrated a higher increase in the metabolic syndrome over the past 30 years when compared to non-Hispanic whites. It is obvious that the burden of obesity is significant in the Hispanic community and this study is quite relevant to our Houston patient population.

Bariatric surgery is the most effective and reliable treatment for morbid obesity and diabetes as well as other obesity related comorbidities. We now have 11 randomized controlled trials demonstrating the superiority of surgical over medical treatment for diabetes. However, the efficacy of bariatric surgery in minority groups in the United States has not been well defined. This report offers a comprehensive evaluation of bariatric surgery outcome in Hispanic patients. It demonstrates that gastric bypass and sleeve surgeries are effective weight loss modalities. There was a significant decrease in insulin, oral hypoglycemic, and hyperlipidemia medications after gastric bypass and gastric sleeve surgery. Interestingly, acid reflux medication reduction or elimination was higher for gastric sleeve patients (40%) compared to 34% for gastric bypass patients. However, these numbers are much lower than the reported rates of 74% in non-Hispanic cohorts. Similarly, excess weight loss was significantly lower in this study group when compared to non-Hispanic white and African American cohorts studied at other large volume bariatric centers.

The retrospective nature of this study has several limitations but does raise some interesting questions. Further prospective and randomized studies are needed to answer these questions. Why are patients of Hispanic origin less successful with gastric sleeve and bypass surgery than other ethnic groups? Is it related to certain genetic differences or lifestyle disparities? Why do patients of Hispanic origin continue with acid reflux medications especially after gastric bypass surgery? Are these medications prescribed to them or bought over the counter? Do they really have acid reflux disease or just treating dyspepsia related symptoms? We hope that additional studies will help answer these questions in the near future.