Minor complication rates higher among Black patients after bariatric procedures

Black patients are more likely to experience minor complications after metabolic and bariatric surgery than White patients, according to new study presented today at the American Society for Metabolic and Bariatric Surgery (ASMBS) 2025 Annual Scientific Meeting.

Researchers from the Yale School of Medicine found Black patients had a higher overall incidence of minor complications such as dehydration, trips to the emergency department (ED) and infections in each of the seven years, growing from 10.2% in 2016 to 15% in 2023 versus 7.6% to 12.1% for White patients. Post-operative visits to the ED not requiring hospital admission, increased from 6.1% to 9.1%, and IV treatments for hydration, from 3.7% to 4.6%. Serious complication (0.4%) and mortality rates (0.1%) remained low throughout the seven years and were about the same for both patient groups.

We were surprised the minor complication rate increased year after year and that racial disparities persisted. More work is needed to identify what's causing the uptick and how it can be reversed. A focus on enhanced discharge education and an action plan surrounding postoperative hydration may be beneficial."

Safraz Hamid, MD, study co-author, Yale School of Medicine

Researchers reviewed the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database to identify 1,106,419 patients (75% White patients, 25% Black patients) who had either primary laparoscopic sleeve gastrectomy (LSG) or Roux-en-Y gastric bypass (RYGB) between 2016 and 2023. Surgical complications were ranked for severity using the Clavien-Dindo system and rates of complications were compared between the two patient groups.

"The study underscores the safety of metabolic and bariatric surgery but also suggests a need to focus more attention on identifying patients at higher risk for minor complications so that we can take measures to prevent them," said ASMBS President Ann M. Rogers, MD, MD, FACS, FASMBS, who was not involved in the study. "This study reveals a trend that we should work to understand better and need to reverse."

According to the U.S. Centers for Disease Control and Prevention (CDC), the prevalence of obesity and severe obesity is 40.3% and 9.4%, respectively. Studies show the disease can weaken or impair the body's immune system and cause chronic inflammation and increase the risk of many other diseases and conditions including cardiovascular disease, stroke, type 2 diabetes, and certain cancers.