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Characteristics Associated with Food Insecurity in Patients Presenting for Bariatric Surgery (P21-019-19).

Objectives
Bariatric surgery is an effective treatment for patients with severe obesity (e.g., BMI > 35). To prevent complications, postoperative patients must comply with dietary requirements and nutritional supplementation. A potential barrier to adherence to dietary requirements is food insecurity (FI). In 2017, the national prevalence of FI was 11.8% and a recent study of a pre-bariatric sample found 18% were FI and 27% were marginally FI. Despite this high prevalence, the characteristics associated with FI in preoperative bariatric patients is not known. The purpose of this study was to identify characteristics associated with FI in a sample of patients presenting to an academic medical center for preoperative bariatric surgery assessment.


Methods
238 participants aged 17-70 with a BMI > 35 were included in the study. Height and weight were measured by clinical staff. Participants completed questionnaires including demographics, the 10-item USDA Adult FI Survey Module (score range 0-10, 0 = food secure, 1-2 = marginal FI, and >3 = FI), the Beck Depression Inventory-II (BDI, range 0-68), the Binge Eating Scale (BES, range 0-48), and the Night Eating Questionnaire (NEQ, range 0-52). An ordinal logistic generalized linear model (GLM) was used with FI as the dependent variable (ordinal, 3 levels) and all variables above as independent variables.


Results
The overall sample had a mean age of 41.1 years and a mean BMI of 48.3. It was predominantly female (75%, n = 180), white (71.3%, n = 171), and had less than a college education (77.1%, n = 185). The overall mean FI, BDI, BES, and NEQ scores were 1.1, 9.0, 13.7, 15.2, respectively. The prevalence of marginal FI was 26% (n = 62) and FI was 15.8% (n = 38). In the GLM, FI was significantly associated with having less than a college education (OR 2.08, P = .04), being non-white (OR 2.12, P = .01), younger age (OR 1.05, P = .002), higher depression scores (1.05, P = .03) and higher night eating scores (1.06, P = .04).


Conclusions
In our sample, the proportion of patients reporting FI was similar to previously reported bariatric samples, and higher than national estimates. Bariatric programs should consider screening for FI as part of routine preoperative evaluations. Further studies are needed to understand the impact of FI on postoperative outcomes.


Funding Sources
None.