Clinical Epidemiology Division, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Int J Obes (Lond). 2021 Apr;45(4):766-775. doi: 10.1038/s41366-021-00737-1. Epub 2021 Jan 25.
BACKGROUND/OBJECTIVES: Bariatric surgery induces durable weight loss and improves health and quality of life. Less is known about how bariatric surgery affects labour market outcomes. This study examined the development of earnings and employment status among women with obesity who underwent bariatric surgery versus matched comparators.
SUBJECTS/METHODS: This study included two cohorts of women in Sweden who gave birth between 1992 and 2014: a cohort with bariatric patients and their full sisters (sister cohort) and a cohort with bariatric patients and comparators matched on BMI, education, birth year, and previous cardiovascular, psychiatric, and musculoskeletal inpatient care diagnoses (BMI-matched cohort). Taxable annual earnings were retrieved from the Swedish Income Tax Register from 2 years before to 5 years after surgery. Employment status was measured dichotomously (employed/not employed) based on earnings data. Adjusted mean and prevalence differences were estimated for earnings and employment by ordinary least squares regression.
The sister cohort included 1400 patient-sister pairs. At baseline, patients and their sisters were of similar age (38.3 vs. 38.6 years) but had different BMI (37.3 vs. 26.7 kg/m). The BMI-matched cohort included 2967 patient-comparator pairs with similar age (36.1 vs. 36.2 years) and BMI (37.1 vs. 37.0 kg/m) before surgery. During follow-up, similar developments of earnings and employment status were observed between bariatric patients and the comparators in both cohorts. When comparing absolute levels of earnings in the sister cohort, the difference in earnings at 2 years before surgery [mean difference -$4137 (95% CI -5245 to -3028)] was similar to the difference in earnings at 5 years after surgery [-$5620 (-7024 to -4215)]. Similar results were found in the BMI-matched cohort, but of smaller magnitude.
Bariatric surgery had little influence on the development of annual earnings and employment for women with obesity in Sweden over 5 years after surgery.
背景/目的：减重手术可持久减轻体重，改善健康状况和生活质量。但对于减重手术如何影响劳动力市场结果，我们的了解还较少。本研究旨在调查接受减重手术的肥胖女性与匹配对照者的收入和就业状况的发展情况。
受试者/方法：该研究纳入了瑞典两个队列的女性，她们在 1992 年至 2014 年间分娩：一个队列为接受减重手术的患者及其全同胞姐妹（姐妹队列），另一个队列为接受减重手术的患者及其按 BMI、教育程度、出生年份和既往心血管、精神科和肌肉骨骼疾病住院治疗诊断进行匹配的对照者（BMI 匹配队列）。从瑞典所得税登记处获取手术前 2 年至手术后 5 年内的应税年收入。根据收入数据，以二元形式（就业/未就业）衡量就业状况。通过普通最小二乘法回归，估计收入和就业的调整平均差异和流行率差异。
姐妹队列纳入了 1400 对患者-姐妹。基线时，患者和她们的姐妹年龄相仿（38.3 岁比 38.6 岁），但 BMI 不同（37.3 千克/平方米比 26.7 千克/平方米）。BMI 匹配队列纳入了 2967 对患者-对照者，他们在手术前的年龄（36.1 岁比 36.2 岁）和 BMI（37.1 千克/平方米比 37.0 千克/平方米）相似。在随访期间，在两个队列中，减重患者和对照者的收入和就业状况均呈现出相似的发展趋势。在姐妹队列中，比较手术前 2 年的收入差异[平均差异为-4137 美元（95%置信区间为-5245 美元至-3028 美元）]与手术后 5 年的收入差异[-5620 美元（-7024 美元至-4215 美元）]相似。在 BMI 匹配队列中也发现了类似的结果，但幅度较小。
在瑞典，肥胖女性接受减重手术 5 年后，手术对其年收入和就业的发展影响不大。
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