July 11, 2025
3 min read
Key takeaways:
- Total weight loss 1 and 2 years after sleeve gastrectomy was lower for Black adults than white and Hispanic adults.
- Black adults had higher HbA1c at 2 years than white and Hispanic adults.
Black adults who underwent a sleeve gastrectomy had a lower total weight loss and higher HbA1c after surgery than white and Hispanic adults, according to study findings published in Obesity.
Previous research on bariatric surgery outcomes has looked primarily at non-Hispanic white adults, Sally M. Vanegas, MS, PhD, research assistant professor in the department of medicine at New York University (NYU) Langone Health, told Healio. To gather more data on other racial-ethnic subgroups, researchers conducted a longitudinal study assessing a wide range of outcomes after sleeve gastrectomy among a group of primarily Hispanic and Black adults.
“The big takeaway is that not everyone benefits from weight-loss surgery in the same way,” Vanegas said. “We found that racial and ethnic differences, along with social and psychological factors, can affect outcomes. This means we need more personalized care to help all patients succeed after surgery.”
Researchers enrolled 297 adults aged 18 to 65 years who underwent a sleeve gastrectomy from June 2017 to March 2020 (69% Hispanic; 20% Black; 11% white). Body measures and laboratory data were collected before surgery and 1.5 months, 3 months, 1 year and 2 years after the procedure. The primary outcomes included the total percentage of body weight lost, HbA1c, homeostasis model assessment of insulin resistance, fasting plasma glucose and fasting insulin.
Weight loss, HbA1c disparities
At 1 year, white adults lost 6.2 percentage points more body weight and Hispanic adults lost 4.9 percentage points more body weight than Black adults. There was no difference in weight loss between white and Hispanic adults.
Melanie Jay, MD, MS, professor of medicine and population health at NYU Langone Health, noted that despite the weight-loss differences, all three groups lost a significant amount of body weight with bariatric surgery.
“Bariatric surgery was still very effective in promoting weight loss in Black patients,” Jay told Healio. “So, we need to make sure that we continue to increase access to these treatments while providing more support.”
Melanie Jay
HbA1c at 2 years was higher among Black adults compared with white adults (5.3% vs. 4.9%; P = .022) and Hispanic adults (5.3% vs. 4.9%; P = .026). There were no differences between the groups in fasting glucose, fasting insulin or insulin resistance.
Waist-to-height ratio did not differ at 2 years between the three groups. Fat mass index decreased more at 2 years among white and Hispanic adults compared with Black adults (P = .029). Fat-free mass index was lower among Hispanic adults than white adults (19.4 kg/m2 vs. 20.8 kg/m2; P = .022) and Black adults (19.4 kg/m2 vs. 20.8 kg/m2; P < .001) at 2 years.
Varying experiences after surgery
In an analysis of self-reported questionnaire responses, white adults had greater concern about body shape at 1 year than Hispanic adults (P = .007), but not Black adults. White adults also reported being most concerned about their weight among the three groups at 1 and 2 years. Black participants reported poorer sleep quality than Hispanic adults at 1 year (P = .002) and 2 years (P = .02). Stress levels were also higher at 1 year for Black adults compared with Hispanic adults (P = .041). Black adults reported experiencing more discrimination at all time points than both Hispanic and white adults.
“These findings show that we need to think beyond surgery itself,” Vanegas said. “The health care community can help reduce disparities by offering more tailored support — like addressing stress, sleep problems and experiences of discrimination — that may affect long-term success. It is about understanding each patient’s unique challenges and providing care that meets their specific needs.”
Jay said the researchers were unable to identify why there were disparities in outcomes, and more research is needed to better understand the associations.
“We need to also go back and do qualitative studies to better understand reasons we may not be thinking of,” Jay said. “And, we have biosample data [that] could look at whether environments, behaviors and other factors impact hormones, epigenetic factors and other biomarkers differentially in different populations.”
For more information:
Melanie Jay, MD, MS, can be reached at melanie.jay@nyulangone.org; Instagram @docmeljay; LinkedIn @drmelaniejay; X @drmelaniejay.
Sally M. Vanegas, MS, PhD, can be reached at sally.vanegas@nyulangone.org.