STATEMENT ATTRIBUTABLE TO: Bruce Wolfe, MD, The Obesity Society Advocacy Committee Member Professor of Surgery and Co-Director of Bariatric Surgery, Oregon Health and Science University Speaking on behalf of The Obesity Society, the Obesity Action Coalition and The American Society for Metabolic and Bariatric Surgery
While a recent JAMA study may raise questions about the economic benefits of bariatric surgery, the data available to these researchers was severely limited. Because most people do not receive healthcare coverage from the same insurance company for several consecutive years, less than half of the total number of bariatric surgery patients included in the study were available for follow-up within two years following surgery. Less than 10 percent of the patients studied were available for follow-up five and six years following surgery. In addition, insurance billing codes do not provide a true assessment of health status. The comparison group may not be entirely equivalent given how poorly obesity and obesity-related complications are coded, as well. Finally, the surgical procedures performed on the majority of patients in the later years of this study are currently used in less than 10 percent of bariatric surgical procedures. It’s clear that any conclusions regarding the healthcare cost of bariatric surgery based on this study must consider these limitations and be made with caution.
This study examined the potential cost savings related to bariatric surgery, but there are several other key considerations—including health benefits, longevity, and quality of life. For example, multiple studies, including an ongoing 20 year study of bariatric surgery from Sweden, have demonstrated a lower incidence of cardiovascular events (heart attack, stroke and others), cancer and death, and with improved quality of life. Still other studies have demonstrated, in addition to those cited in the JAMA editorial, long-term cost savings following bariatric surgery. Further, a 2012 review of the cost-efficacy of bariatric surgery by Lorenzo Terranova in Obesity Surgery, which took into account studies that examined quality of life, concluded that bariatric surgery provided considerable benefits at a reasonable cost.
Indeed, let’s put the health, longevity and quality of life of people affected by obesity first, rather than focusing solely on the cost. What really counts for everyone affected by chronic illness are the real and lasting benefits of groundbreaking treatments. Today, bariatric surgery remains, by far, the most effective treatment we have for severe obesity. At present, we have no other interventions that achieve return on investment like bariatric surgery in patients with severe obesity.
As the authors of the recent JAMA article agree: “to assess the value of bariatric surgery, future studies should focus on the potential benefit of improved health and well being of persons undergoing the procedure rather than on cost savings.”
About The Obesity Society (TOS)
TOS is the leading scientific society dedicated to the study of obesity. TOS is committed to encouraging research on the causes, treatment, and prevention of obesity as well as to keeping the scientific community and public informed of new advances in the field. For more information please visit: www.obesity.org.
About the Obesity Action Coalition (OAC)
The OAC is a National nonprofit charity dedicated to helping individuals affected by obesity. The OAC was formed to bring together individuals struggling with weight issues and provide educational resources and advocacy tools. For more information please visit: www.obesityaction.org.
About the American Society for Metabolic and Bariatric Surgery (ASMBS)
The ASMBS is the largest organization for bariatric and metabolic surgeons and integrated health professionals in the world. It is a nonprofit organization that works to advance the art and science of bariatric surgery and is committed to educating medical professionals and the lay public about bariatric surgery as an option for the treatment of morbid obesity, as well as the associated risks and benefits. It encourages its members to investigate and discover new advances in bariatric surgery, while maintaining a steady exchange of experiences and ideas that may lead to improved surgical outcomes for patients who are affected by obesity. For more information, visit: www.asmbs.org.