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Obesity Surgeries Up Dramatically

January 11, 2007

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Obesity surgeries for patients between the ages of 55 and 64 in the United States soared from 772 procedures in 1998 to 15,086 surgeries in 2004 -- a nearly 2,000 percent increase, according to a new report by HHS' Agency for Healthcare Research and Quality (AHRQ).

The report, the latest of several studies that AHRQ has done on obesity surgery, also found a 726 percent increase in surgeries among patients age 18 to 54. There were a total of 121,055 surgeries performed on patients of all ages in 2004.

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

Certain procedures, known collectively as bariatric surgery, have been proven beneficial in obese people 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."

Doctors may recommend bariatric surgery for patients who have a Body Mass Index 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 Carolyn M. Clancy, M.D. "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 also found that:

• Patients ages 18 to 54 still account for the highest number of surgeries: 103,097 bariatric surgeries, or 85 percent of the total.

• Adolescents ages 12 to 17 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 percent of the total.

• The in-hospital death rate for men in 2004 was only 0.4 percent, 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 -- which reduces the size of the stomach and bypasses a section of the intestines to decrease food absorption -- accounted for 94 percent of bariatric procedures.

• The average hospital cost for a bariatric surgery patient stay, excluding physician fees, was $10,395 in 2004 as compared with $10,970 in 1998, adjusted for inflation.

• The vast majority (78 percent) of bariatric surgery patients were privately insured. Only 5 percent of patients were uninsured, but their numbers increased by 810 percent over the period.

• 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 percent.

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