Impact of bariatric surgery on monthly earnings and employment: a national linked data study in England, 2014-2022

ObjectiveEvaluate the impact of bariatric surgery on monthly earnings and employee status among working-age adults, and examine variations across sociodemographic characteristics. DesignRetrospective longitudinal cohort study using national, linked administrative datasets. SettingHospital inpatient services in England between 1 April 2014 and 31 December 2022. Participants40,662 individuals who had a bariatric surgery procedure and obesity diagnosis during the study period, with no bariatric surgery history in the previous 5 years, and were 25 to 64 years old at the date of surgery. We also included 49,921 individuals sampled from the general population who had not had bariatric surgery matched by age and sex to those in the cohort who had bariatric surgery. Main outcome measuresMonthly employee pay - for all months and only months where the individual was in paid employment - expressed in 2023 prices; paid employee status. ResultsAmong people living with obesity who had bariatric surgery, there was a sustained increase in monthly employee pay from six months after surgery with a mean increase of {pound}84 per month 5 years after surgery compared with the six months before surgery. Among those in paid employment, there was a sustained increase in the probability of being a paid employee from 4 months after bariatric surgery, with a mean increase of 4.3 percentage points 5 years after surgery. The increases in pay and probability of employment were greater for males. The increase in employee pay was not sustained over the 5-year follow up time for the youngest age groups. ConclusionsBariatric surgery is associated with an increased probability of being employed, resulting in increased earnings. These findings suggest that living with obesity negatively impacts labour market outcomes and that obesity management interventions are likely to generate economic benefits both to individuals and on a macroeconomic level by increasing the likelihood of employment of people living with obesity.