rates for bariatric surgery on the rise, especially among youth, U-M
of Michigan Health System
1996-2002, bariatric surgery increased seven-fold, tripling among
youth, with private insurers charged with 80 percent of the cost
in 2002 alone
the rate of national obesity has steadily increased across all age
groups, so has Americans willingness to turn to an effective
surgical intervention to address severe obesity: bariatric surgery.
1996 to 2002 the use of bariatric surgery has increased seven-fold
nationally, and its use has more than tripled among youth. More
than 80 percent of individuals in all age groups who underwent the
procedure were female.
findings, from researchers at the University of Michigan Health
System, also reveal that in 2002 alone, hospitals charged more than
$2 billion for bariatric surgery, with private insurers picking
up more than 80 percent of the charges.
from this study, which also examine the most common medical conditions
among youth who undergo bariatric surgery, are reported in the January
issue of Archives of Surgery.
surgery, which includes procedures such as gastric bypass, gastric
banding and biliopancreatic diversion, aims to change the gastrointestinal
tract so it restricts the amount of food a person is able to consume.
the nations waistline has continued to grow, so has the popularity
of this weight loss procedure as more Americans work to combat their
obesity after failed attempts at diet and exercise. The procedure
is recommended only for individuals with severe obesity, or for
those who are obese and suffering from other medical complications
of obesity such as diabetes.
greatest increase in bariatric surgery rates has occurred among
non-elderly adults, and, for the first time, weve seen
that bariatric surgery rates have increased among the nations
youth, more than three-fold from 1996 to 2002, notes study
lead author Matthew M. Davis, M.D., M.A.P.P., an assistant professor
of pediatrics, internal medicine and public policy in the Child
Health Evaluation and Research (CHEAR) Unit in U-M C.S. Mott Childrens
Hospitals Division of General Pediatrics.
Davis says key aspects of this national trend the female
to male ratio among patients undergoing the procedure in various
age groups, additional medical conditions patients may have beyond
obesity, and the economic implications of the procedure remained
unclear and required closer examination.
data from Nationwide Inpatient Sample (NIS), a database of discharge
information developed by federal and state governments and health
care institutions, Davis and his colleagues analyzed the most recent
data available,1996 through 2002, to examine trends in the use of
the study, individuals who had undergone bariatric surgery were
characterized according to gender, age, and other medical conditions,
or comorbidities, they may have in addition to obesity. Their hospitalization
was examined based on length of stay, average hospital charges,
expected primary payer, and in-hospital mortality.
the study revealed that rates of bariatric surgery climbed seven-fold
from 1996 through 2002, with increases in all age groups studied:
youth (younger than 20 years of age), non-elderly (20 to 65 years
of age) and elderly (older than age 65).
this increase is having a noticeable impact on health insurance:
in 2002, hospitals charged more than $2 billion for these procedures,
with more than 80 percent billed to private insurers. On average,
each hospital stay in 2002 for bariatric surgery led to about $29,000
payers are shouldering an increased share of the costs for bariatric
surgery, and this trend is most likely a result of increased coverage
among private payers for this procedure, which has a track record
of success compared to other therapies for obesity, says Davis.
Bariatric surgery appears to be an increasingly attractive
option for private insurance plans and employers that face rapidly
growing health care costs associated with obesity and related comorbidities.
the greatest increase in bariatric surgery rates occurred among
non-elderly adults, Davis says this is the first study of its kind
to report that bariatric surgery rates also have grown among Americas
youth, with bariatric procedures in this age group more than tripling
during the time period studied.
previous national studies on bariatric surgery, Davis research
further identified the most common comorbidities among youths undergoing
bariatric surgery. In 2002, comorbidities of obese youth were: depression
(17 percent), high blood pressure (14 percent), esophageal reflux
(14 percent), sleep apnea (11 percent), chronic gallstones (11 percent),
and asthma (8 percent).
findings among the youth population also mirrored those of the non-elderly
group in the study. In both age groups, women were four times more
likely to undergo bariatric surgery than men.
finding suggests that, in addition to medical factors, there are
likely some social factors playing into the decision to undergo
bariatric surgery that leads to young women being more likely, and
young men less likely, to have the procedure, says Davis,
noting that other national data indicate a more balanced gender
ratio among youth in relation to severe obesity.
with Davis, the study was co-authored by Kathryn Slish, MA, Department
of Pediatrics at the U-M Health System; Celia Chao, M.D., Department
of Surgery at the University of Texas Medical Branch; and Michael
D. Cabana, M.D., MPH, Department of Pediatrics at the University
of California at San Francisco.
study was funded by the U-M Health System.
Reference: Archives of Surgery, January 2006, Vol.141.
University of Michigan Health System