BACKGROUND:Weight loss after gastric bypass can be impacted by a variety of demographic factors including age, sex, and body mass index (BMI). Race has also been implicated as a predictive factor for weight loss, with African Americans (AA) losing less weight after surgery compared to other ethnic groups (non-AA). Although, there is little data addressing this potential association, some investigators have suggested that African Americans might benefit from more malabsorptive operations in order to augment weight loss. The main outcome measure after obesity surgery, however, is resolution or prevention of obesity related medical disease. The impact of race on resolution of medical disease is largely unknown.METHODS:Data collected prospectively from 505 consecutive patients undergoing gastric bypass over a seven year period were reviewed. All patients underwent a long-limb gastric bypass with a 150cm roux limb. Weight loss was calculated as percent excess weight loss (%EWL) and complete resolution of medical disease was defined as the termination of medications and normalization of appropriate clinical criteria.RESULTS:84 patients were African American (AA) and 421 patients were non-AA. The AA and non-AA groups were similar with respect to percent male (17.8% vs 18.5%), pre-op BMI (57.8 vs 54.8), and pre-op incidence of diabetes (23.8% vs 28%), hypertension (54.8% vs 47.5%), and sleep apnea (28.6% vs 37.5%). Percent EWL in the AA group was significantly lower at one and two years post-op (54% and 57%) compared to the non-AA group (63% and 69%; p<.05). The impact on obesity related medical disease, however, was similar between the AA and non-AA groups including complete resolution of diabetes (78.6% and 76.7%), hypertension (76.9% and 70.5%), and sleep apnea (90.9% and 93.6%) respectively. Post-op morbididy was 11.9% for AA's (no deaths/no leaks) and 10.9% for non-AA's (including 2 deaths/one leak).CONCLUSION:Although AA patients demonstrate less percent excess weight loss compared to non-AA patients, they enjoy the same benefits of gastric bypass including similar resolution rates of diabetes, hypertension, and sleep apnea without an increase in perioperative complications. Further studies are needed to investigate potential mechanisms that may account for the impact of race on weight loss.