Post-surgical weight loss increases work productivity

Patients who had bariatric surgery that resulted in weight loss, improved physical function or reduction in depressive symptoms also reduced their absenteeism at work, according to a Researcher Letter published in JAMA. It is well-known that obesity is associated with sick leave, disability, and work-place injuries and bariatric surgery is an effective treatment for patients with severe obesity. However, the evidence is limited regarding the relationship between bariatric surgery and work productivity.

In the study, ‘Longitudinal Evaluation of Work Status and Productivity After Bariatric Surgery’, Dr David R Flum of the University of Washington, Seattle, and colleagues assessed working status and change in productivity in the first three years following bariatric surgery for severe obesity.

This study included adults with severe obesity undergoing bariatric surgery who completed a work productivity and activity impairment questionnaire pre-surgery and annually post-surgery. Work status among non-retirees and past-week work absenteeism (missed work due to health) and presenteeism (impaired work due to health) among employed participants were assessed.

Of 2,019 non-retired participants, 89 percent had work factors data at one or more follow-up assessment(s) and were included in the analysis. Baseline median age was 45 years; median body mass index was 46; 80 percent were women. Weight loss was 28 percent at three years. Prevalence of employment or disability did not significantly change throughout follow-up. However, unemployment increased from pre-surgery to year three (3.7 percent for pre-surgery vs 5.6 percent for year three post-surgery).

Of 1,265 employed participants, 86 percent were included in the work productivity sample. Prevalence of absenteeism was lower at year one (10.4 percent) vs pre-surgery (15.2 percent), but did not significantly differ from pre-surgery at year two or three. Prevalence of presenteeism was lower than pre-surgery at all post-surgery times but increased from years one to three.

Improvements in physical function and depressive symptoms were independently associated with lower risks of post-surgery absenteeism and presenteeism, whereas post-surgery initiation or continuation of psychiatric treatment vs no treatment pre-surgery or post-surgery was associated with higher risks. Greater weight loss was independently associated with lower risk of post-surgery presenteeism only.

“In this large cohort of adults who underwent bariatric surgery, patients maintained working status and decreased impairment due to health while working,” the researchers conclude. “The small increase in unemployment by year three may reflect a secular trend in unemployment during the time of the study; the annual average rate of unemployment increased from 4.5 percent in 2007 to 8 percent in 2012. The reduction in presenteeism following surgery may be explained by weight loss, improved physical function, or reduction in depressive symptoms. The increase in presenteeism between years one and three may reflect an adaptation to a new health state or deterioration of initial pre-surgery to post-surgery improvements.”

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