MAY 11, 2017 BY MOLLY SKUBAK

What We’re Learning: Changes in Preventive Health Care Services After Bariatric Surgery

One of the first research questions that the PaTH Healthy Lifestyles and Weight researchers are tackling is focused on obesity. The analysis is being led by Michelle Lent, Ph.D., of Geisinger Health System, who recently spoke with us about the paper, and Sharon Herring, M.D., from Temple University. The paper will explore how the use of preventive health care services changes after bariatric surgery.

Researchers will look at clinical data – such as procedural codes for mammography – for female bariatric surgery patients age 53 or above from all PaTH sites to see how frequently they received preventive screenings prior to their surgery compared to three years after their surgery. The study will primarily focus on how often patients undergo mammography but will also evaluate changes in colorectal and cervical cancer screening and influenza vaccine use. In addition to seeing whether preventive health care changes following surgery, the team will determine whether patients from different racial/ethnic backgrounds have differences in their use of preventive medicine services.

"We have such a varied group of patients from different geographic locations and of different races and ethnicities, we thought [PaTH] would be an ideal dataset to explore this research question."

Dr. Lent says a number of factors could prevent or deter women with obesity, or a body mass index of 30 or higher, from seeking preventive screenings.

"As a clinical psychologist I hear frequently how difficult it is for individuals living with obesity to face the world, including their health care providers" says Dr. Lent. "Some patients with obesity perceive bias from health care professionals because they feel judged about their weight, or they don’t want to have the conversation about their weight."

Several studies indicate that white women who have obesity do not visit a doctor to get their preventive screenings as much as women with healthy weight. These preventive screenings – such as mammograms and Pap smears – are an important factor in women’s health, and failing to receive them can lead to further health issues.

Through her previous research on weight bias in bariatric surgery patients, Dr. Lent has found that perceived weight bias before surgery correlates with less weight loss after surgery, meaning patients who feel they are treated differently because of their weight are less likely to achieve or maintain a healthy weight after bariatric surgery.

“Weight bias has always been of interest of me,” says Dr. Lent. "If patients feel judged about their weight, they may be less motivated to make behavioral changes."

Dr. Lent says she "hopes barriers to health care improve after bariatric surgery." If that is the case and this study finds that women do get more preventive screenings after bariatric surgery, it will add to the potential health benefits of bariatric surgery.

"It takes a lot for patients to get through the bariatric surgery process and make lifestyle and diet changes for the rest of their lives. I think these data could help patients have greater access to bariatric surgery by giving insurance companies more data about additional benefits it can provide."

Currently, PaTH informatics experts are pulling data that will then be analyzed by a statistician at Temple. To learn more about PaTH’s work with Healthy Lifestyles and Weight, visit our website.

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