Retrospective Analysis of Racial Disparities in Weight Regain and Cardiovascular Outcomes Following Bariatric Surgery

Introduction: Bariatric surgery (BS) is currently considered the gold standard treatment for obesity, leading to significant weight loss and improvements in cardiometabolic health. However, weight regain after surgery is still a common challenge, and the role of sociodemographic factors, particularly ethnicity, in influencing long-term outcomes is not fully understood. Hypothesis: We hypothesize that ethnic differences may contribute to variations in weight loss trends and postoperative outcomes, including weight regain and changes in comorbidities. This study aims to analyze a cohort of patients at UI Health (Chicago) who underwent bariatric surgery from 2018 to 2023, focusing on weight loss trajectories, comorbidities, and the impact of ethnicity on postoperative outcomes. Methods: We conducted a retrospective analysis of 341 patients, who were classified by ethnicity (African American, Hispanic, White, and other). Data collected included preoperative history, type of bariatric surgery performed (e.g., gastric bypass, sleeve gastrectomy), presence of hypertension (HTN) and type 2 diabetes (T2D), blood pressure, glucose and lipid profile, BMI, and new diagnoses after surgery. In addition, we documented the number of follow-up visits and postoperative weight changes. Our primary outcome was to assess the incidence of weight regain, its timing after surgery, and its correlation with changes in blood pressure. Results: Among the cohort (304 females and 37 males), most of the patients were African American (60.7 percent), followed by Hispanics (23.7 percent), whites (12.6 percent), and 2.9 percent of other ethnicities. The most frequently performed type of surgery was laparoscopic sleeve gastrectomy, (273 patients), of which 100 were performed with the help of the Da Vinci robot. Preoperative comorbidities included HTN and T2D, with a high incidence of metabolic dysfunction. Of the 357 patients, 111 (31%) regained weight by the 6th year of follow-up, with the highest incidence between the 1st and 2nd years postoperatively (53 patients). Weight regain was more pronounced among women than men (97 vs. 14), particularly in African Americans (63 overall) and Hispanics (20). Blood pressure was significantly reduced after surgery in most patients. However, those who regained weight showed less improvement or even a slight increase in blood pressure than those who maintained weight loss. Conclusions: These results suggest that ethnicity plays a determining role in bariatric surgery outcomes, highlighting that African American and Hispanic patients are more susceptible to weight regain than their White counterparts. In addition, weight regain after surgery is associated with less favorable cardiovascular health outcomes, considering the changes in blood pressure in these patients. More analyses are being conducted to link weight regain to other parameters, such as glucose and lipid profiles, as well as bile acid metabolism and liver function. This project was funded by the National Institute of Health grant number R01HL161386 (Principal Investigator AMM). This abstract was presented at the American Physiology Summit 2025 and is only available in HTML format. There is no downloadable file or PDF version. The Physiology editorial board was not involved in the peer review process.