Systematic Review and Meta-Analysis of Occupational Outcomes after Bariatric Surgery.

INTRODUCTION: Obesity has been linked with reduced productivity in the workplace and is associated with higher levels of unemployment and absenteeism. Studies have shown improvement in functioning and enhanced activity levels in patients after bariatric surgery.

OBJECTIVES: We perform a systematic review and meta-analysis of the literature to assess the impact of bariatric surgery on occupational outcomes.

METHODS: Medline, Embase, The Cochrane Library and NHS Evidence were searched for English language studies assessing factors related to employment both preoperatively and postoperatively.

RESULTS: The initial search produced 189 results. Ten studies met our inclusion criteria and were included in the review. Meta-analysis did not suggest a significant improvement in overall employment rates after surgery (RR 1.058, p = 0.155). However, pooled analysis of studies analysing unemployed patients separately demonstrates that 26.4 % (95 % CI 21.6-31.5 %) of unemployed patients are able to return to work after bariatric surgery. Pooled analysis on two studies suggests that those undergoing surgery are 3.24 (p = 0.01) times more likely to return to work than non-surgical controls. Three studies demonstrated significant reductions in the mean number of annual sick days.

CONCLUSIONS: There is limited evidence in the literature regarding occupational outcomes following bariatric surgery, and further studies are required before firm conclusions can be drawn. However, the existing evidence does suggest that bariatric surgery has a generally positive impact on occupational outcomes. This suggests that surgery may have wider economic, social and psychological benefits above and beyond its immediate health benefits.