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Amy J. Wagner, MD; Joseph M. Fabry Jr, DO; Richard C. Thirlby, MD

Arch Surg. 2007;142(10):935-940.

Objective  To determine whether medically disabled (Medicaid-funded) morbidly obese patients return to the workforce after Roux-en-Y gastric bypass (RYGB).

Design  Retrospective clinical data review.

Setting  A tertiary referral center.

Patients  From January 1, 1997, to December 31, 2002, 38 medically disabled patients underwent RYGB performed by a single surgeon. Sixteen medically disabled patients seen by the same surgeon did not undergo surgery and served as a control group.

Intervention  Roux-en-Y gastric bypass.

Main Outcome Measure  Full-time employment.

Results  The patients who underwent RYBG were more likely to return to work, with 14 (37%) working, compared with 1 (6%) of the nonoperative control patients (P = .02). Elimination of comorbidities was associated with a greater likelihood of return to work. Patients who had greater than the mean decrease in comorbid conditions at the time of follow-up were statistically more likely to return to work than those who did not have a reversal in comorbid conditions (P = .001). Health-related quality of life was very poor preoperatively and improved in all domains after surgery.

Conclusions  Morbid obesity is associated with many medical conditions that often render patients disabled. We found that 37% of morbidly obese patients with Medicaid coverage returned to work after RYGB, compared with 6% of patients in the nonoperative control group. This study suggests that RYGB, the most effective available means to achieve durable weight loss and reduction of comorbidities in morbidly obese patients, results in significant rehabilitation of Medicaid-funded morbidly obese individuals.

Author Affiliations: Department of General, Vascular, and Thoracic Surgery, Virginia Mason Medical Center, Seattle, Washington.

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