Background

Lower socioeconomic status (SES) is a risk factor for obesity and may predict suboptimal weight loss following bariatric surgery (BS). The identification of specific challenges associated with lower SES is critical to developing interventions to address them. We examined how SES and ethnicity impact baseline nutritional knowledge (NK) and eating behaviors among a population presenting to a bariatric surgery clinic (BSC).

Methods

Patients at initial visit to BSC (n=32) completed an online survey comprised of the General Nutritional Knowledge Questionnaire (GNKQ), Adult Eating Behavior Questionnaire (AEBQ), and questions related to SES and ethnicity including highest level of education and yearly income. All patients were English speaking. Significance among groups was determined using ANOVA test.

Results

Lower income, lower education level, and Hispanic ethnicity were significantly associated with lower mean GNKQ scores (p<0.045, p<0.036, p<0.034). Lower income and Hispanic ethnicity were significantly associated with increased Emotional Under Eating (EUE) scores from the AEBQ (p<0.007, p<0.026).

Conclusions

Our study demonstrates that lower SES and Hispanic ethnicity are associated with lower general NK. This association suggests an explanation as to why obesity is more prevalent in these groups, and affords an opportunity to address disparate outcomes following bariatric surgery. Specifically, bariatric surgery centers should aim to address the deficit in nutrition knowledge with comprehensive nutritional education. The association of lower income and Hispanic ethnicity with EUE, as defined as eating less in response to negative emotions, is novel and suggests another opportunity to improve outcomes in these populations.