Effect of bariatric surgery on employment status—a 7 years controlled nationwide registry study

Background Severe obesity is associated with a reduced ability to work. Bariatric surgery is the most effective method to achieve a sustained weight loss. Previous studies have reported conflicting results regarding the effect of bariatric surgery on employment status. To address this, we investigat...

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Main Authors: René Holst, Jon Michael Gran, Claus Bogh Juhl, Lene Hymøller Mundbjerg, Charlotte Stolberg, Gert Frank Thomsen
Format: Article
Language:English
Published: BMJ Publishing Group 2021-06-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/11/6/e042845.full
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author René Holst
Jon Michael Gran
Claus Bogh Juhl
Lene Hymøller Mundbjerg
Charlotte Stolberg
Gert Frank Thomsen
author_facet René Holst
Jon Michael Gran
Claus Bogh Juhl
Lene Hymøller Mundbjerg
Charlotte Stolberg
Gert Frank Thomsen
author_sort René Holst
collection DOAJ
description Background Severe obesity is associated with a reduced ability to work. Bariatric surgery is the most effective method to achieve a sustained weight loss. Previous studies have reported conflicting results regarding the effect of bariatric surgery on employment status. To address this, we investigated the effect of bariatric surgery on employment status in the Danish population.Methods In this nationwide study, we identified 5450 subjects who underwent bariatric surgery and 10 900 control subjects matched for age, sex and municipality. From accessible registries, we extracted data regarding employment, absenteeism, sick leave and pension. Using a multistate model, we compared time in occupational states and transitions between these states to determine the effect of bariatric surgery on employment status.Findings Before surgery, cases had an absolute risk increase (95% CI)(ARI (CI)) and a relative risk (RR (CI)) of being in full-time employment of −0.12 (−0.14 to −0.10) and 0.84 (0.82 to 0.86) and were more often unemployed or in a subsidised job than the background population. Taking into account the employment status before surgery, the bariatric surgery group increased their probability of being in full-time employment 1–3 years after bariatric surgery. However, this positive effect was not present with a longer duration of follow-up. Being male, above 50 years of age, or employed as a craftsman or office worker were associated with a sustained positive effect of being in full-time employment (ARI (CI) and RR (CI) 0.05 (0.04 to 0.05) and 1.05 (1.04 to 1.06), 0.06 (0.06 to 0.07) and 1.08 (1.07 to 1.09) and 0.05 (0.05 to 0.06) and 1.05 (1.05 to 1.06), respectively).Interpretation Compared with a matched control group, those undergoing bariatric surgery did not improve their employment status in the long term. Certain subgroups had a more sustained positive effect.
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spelling doaj-art-eed3cf21c62d49178f63f63e6347ce9c2024-11-20T09:15:08ZengBMJ Publishing GroupBMJ Open2044-60552021-06-0111610.1136/bmjopen-2020-042845Effect of bariatric surgery on employment status—a 7 years controlled nationwide registry studyRené Holst0Jon Michael Gran1Claus Bogh Juhl2Lene Hymøller Mundbjerg3Charlotte Stolberg4Gert Frank Thomsen5Oslo Centre for Biostatistics and Epidemiology, Faculty of Medicine, University of Oslo, Oslo, NorwayFaculty of Medicine, Department of Biostatistics, University of Oslo, Oslo, NorwayDepartment of Endocrinology, Sydvestjysk Sygehus Esbjerg, Esbjerg, DenmarkDepartment of Endocrinology, Hospital of South West Jutland, Esbjerg, DenmarkDepartment of Endocrinology, Hospital of South West Jutland, Esbjerg, DenmarkDepartment of Occupational Medicine, Hospital of South West Jutland, Esbjerg, DenmarkBackground Severe obesity is associated with a reduced ability to work. Bariatric surgery is the most effective method to achieve a sustained weight loss. Previous studies have reported conflicting results regarding the effect of bariatric surgery on employment status. To address this, we investigated the effect of bariatric surgery on employment status in the Danish population.Methods In this nationwide study, we identified 5450 subjects who underwent bariatric surgery and 10 900 control subjects matched for age, sex and municipality. From accessible registries, we extracted data regarding employment, absenteeism, sick leave and pension. Using a multistate model, we compared time in occupational states and transitions between these states to determine the effect of bariatric surgery on employment status.Findings Before surgery, cases had an absolute risk increase (95% CI)(ARI (CI)) and a relative risk (RR (CI)) of being in full-time employment of −0.12 (−0.14 to −0.10) and 0.84 (0.82 to 0.86) and were more often unemployed or in a subsidised job than the background population. Taking into account the employment status before surgery, the bariatric surgery group increased their probability of being in full-time employment 1–3 years after bariatric surgery. However, this positive effect was not present with a longer duration of follow-up. Being male, above 50 years of age, or employed as a craftsman or office worker were associated with a sustained positive effect of being in full-time employment (ARI (CI) and RR (CI) 0.05 (0.04 to 0.05) and 1.05 (1.04 to 1.06), 0.06 (0.06 to 0.07) and 1.08 (1.07 to 1.09) and 0.05 (0.05 to 0.06) and 1.05 (1.05 to 1.06), respectively).Interpretation Compared with a matched control group, those undergoing bariatric surgery did not improve their employment status in the long term. Certain subgroups had a more sustained positive effect.https://bmjopen.bmj.com/content/11/6/e042845.full
spellingShingle René Holst
Jon Michael Gran
Claus Bogh Juhl
Lene Hymøller Mundbjerg
Charlotte Stolberg
Gert Frank Thomsen
Effect of bariatric surgery on employment status—a 7 years controlled nationwide registry study
BMJ Open
title Effect of bariatric surgery on employment status—a 7 years controlled nationwide registry study
title_full Effect of bariatric surgery on employment status—a 7 years controlled nationwide registry study
title_fullStr Effect of bariatric surgery on employment status—a 7 years controlled nationwide registry study
title_full_unstemmed Effect of bariatric surgery on employment status—a 7 years controlled nationwide registry study
title_short Effect of bariatric surgery on employment status—a 7 years controlled nationwide registry study
title_sort effect of bariatric surgery on employment status a 7 years controlled nationwide registry study
url https://bmjopen.bmj.com/content/11/6/e042845.full
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