Obesity surgeries have jumped dramatically since 1998

January 16, 2007

ST LOUIS (MD Consult) - Obesity surgeries for patients aged 55 to 64 years in the United States soared from 772 procedures in 1998 to 15,086 procedures in 2004—a nearly 2,000% increase, according to a new report released on January 10, 2007, by the Agency for Healthcare Research and Quality (AHRQ). The report, the latest of several studies that the AHRQ has conducted on obesity surgery, also found a 726% increase in surgeries among patients aged 18 to 54 years. A total of 121,055 surgeries were performed on patients of all ages in 2004.

Among the reasons for the extremely dramatic increases is that mortality outcomes from obesity surgery have improved greatly. The national death rate for patients hospitalized for bariatric surgery declined 78%, from 0.9% in 1998 to 0.2% in 2004.

Certain procedures, known collectively as bariatric surgery, have been proven beneficial in obese persons who have tried and failed to lose excess weight by diet, exercise, and other means. The surgical procedures include gastric bypass operations, vertical-banded gastroplasty, and gastric banding or "lapband." Physicians may recommend bariatric surgery for patients who have a body mass index (BMI) of 40 or greater—a person who is 5 feet 2 inches tall and weighs 276 pounds, for example—or a BMI of 35 or more for patients who have serious, obesity-related medical conditions such as type 2 diabetes or severe sleep apnea.

"This report shows that more Americans are turning to obesity surgery and that an increasing number of younger people are undergoing these procedures," said AHRQ Director Dr Carolyn M. Clancy. "As the rate of obesity continues to climb, the health care system needs to be prepared for continued escalation in the rate of this surgery and its potential complications."

The report, which is posted on the AHRQ Web site, also found that:
patients aged 18 to 54 years still account for the highest number of surgeries—103,097 bariatric surgeries, or 85% of the total;
adolescents aged 12 to 17 years accounted for 349 bariatric procedures in 2004;
women have bariatric surgery more often than men—they accounted for more than 99,000 operations, or 82% of the total;
the in-hospital death rate for men in 2004 was only 0.4%, but it was 2.8 times higher than that of women—in 1998, the in-hospital death rate for men was six times higher than that of women;
gastric bypass surgery accounted for 94% of bariatric procedures;
the average hospital cost for a bariatric surgery patient stay, excluding physician fees, was $10,395 in 2004 compared with $10,970 in 1998, adjusted for inflation;
the vast majority (78%) of bariatric surgery patients were privately insured—only 5% of patients were uninsured, but their numbers increased by 810% over the period; and
the overall hospital costs for bariatric surgery patients increased more than eight-fold—from $147 million in 1998 to $1.3 billion in 2004. However, the average cost per patient decreased by 5%.
For complete details, see "Bariatric Surgery Utilization and Outcomes in 1998 and 2004, HCUP Statistical Brief 23" at http://www.hcup-us.ahrq.gov/reports/statbriefs/sb23.pdf .