S744 Underutilization and Racial Disparities in Obesity Management in the United States

Introduction: Obesity is a prevalent health problem in the United States with significant racial disparities in both the prevalence and access to treatment. Bariatric surgery and glucagon-like peptide-1 receptor agonists (GLP-1RAs) are 2 of the most effective interventions for obesity and their utilization across racial groups is not well studied. This study aims to evaluate disparities in access to bariatric surgery and GLP-1RA medications based on race and gender. Methods: We conducted a retrospective study using data from the TriNetX US Collaborative Network, which includes electronic health records from 61 healthcare organizations. We included patients with severe obesity defined as body mass index (BMI) ≥40 kg/m². Patients were divided into 2 cohorts: Cohort 1 included African American (AA) adult patients, while Cohort 2 included White adult patients. Separate analyses were conducted for men and women. Outcomes were measured over a 10-year period and included undergoing bariatric surgery and the use of glucagon-like peptide-1 receptor agonists (GLP-1RA) medications (semaglutide, liraglutide, and tirzepatide). Propensity score matching was used to balance cohorts according to age, comorbidities, and body mass index. Results: AA men had significantly lower rates of bariatric surgery (1.1% vs 1.4%, RR: 0.79, P < 0.001) and GLP-1RA utilization compared to White men (5.6% vs 6.7%, RR: 0.84, P < 0.001). No significant difference was observed between AA and White women (2.5% vs 2.4%, RR: 1.01, P = 0.508) in access to bariatric surgery, while utilization of GLP-1RA was slightly lower in AA women (6.2% vs 6.6%, RR: 0.94, P < 0.001). Furthermore, both types of obesity treatment were underutilized overall, specifically in adult males. Conclusion: Racial disparities in access to surgical and pharmacological obesity treatments are more prevalent among male populations (AA vs White) compared to female populations. AA men were less likely to receive bariatric surgery and GLP-1RA medications. Moreover, obesity treatments remain largely underutilized in the population as a whole, and this is more pronounced in men compared to women. Targeted strategies are needed to ensure equitable access and removal of barriers to treatment across different patient groups.