Bariatric Surgery on the Rise, Especially Among Youth

As 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.

From 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.

These 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.

Results 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.

Bariatric 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.

As the nation's 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.

"The greatest increase in bariatric surgery rates has occurred among non-elderly adults, and, for the first time, we''ve seen that bariatric surgery rates have increased among the nation's 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 Children's Hospital's Division of General Pediatrics.

However, 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.

Using 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 bariatric surgery.

For 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.