- The Washington Times - Monday, July 11, 2005

Weight-loss surgeries in the United States shot up more than fivefold in five years, says a medical report released today.

The report, published in the policy journal Health Affairs, says the number of bariatric surgeries performed jumped from 13,386 in 1998 to 71,733 in 2002.

The operation generally involves restricting the size of a patient’s stomach and bypassing part of the intestines to reduce food absorption.

The trend is expected to continue because fewer than 1 percent of clinically eligible patients in the United States underwent bariatric surgery in 2002, said William Encinosa, a co-author and senior analyst at the federal Agency for Healthcare Research and Quality.

“That means the potential demand for this service is very high, so we expect a much higher use of the surgery in the future,” he said.

Part of the reason for the increase has been a lower postoperative patient death rate, down to 0.32 percent in 2002 from nearly 1 percent in 1998, the report said.

But dangerous side effects and risks remain, said Peggy Howell, spokeswoman for the National Association to Advance Fat Acceptance, an Oakland, Calif., advocacy group.

“People we know who had [the surgery] end up gaining the weight back,” she said.

Dr. Christine Gerbstadt, an anesthesiologist and dietitian in Altoona, Pa., said 20 percent of surgery patients regain their weight.

“This is primarily from patients who have not changed their eating habits and are tricking their bodies into bypassing the bypass surgery,” Dr. Gerbstadt said.

The length of hospital stays fell 24 percent to 3.8 days in 2002, the report said, but the average cost per surgery rose 13 percent from $11,705 in 1998 to $13,215 in 2002. The report did not include more recent data.

Because the federal government has no national estimates on the use and cost of bariatric surgeries, Mr. Encinosa and his team based their findings on national hospital and insurance claims data.

The government and the private sector have launched efforts to stem the nation’s rising obesity rate.

The Centers for Disease Control and Prevention reports that about 64 percent of U.S. adults are overweight or obese.

Although most of the bariatric surgeries in 2002 were performed on privately insured patients, federal health insurance programs such as Medicare and Medicaid covered 11 percent of the operations, the study said.

The Centers for Medicare and Medicaid, which runs the health programs, announced nearly a year ago that the government might cover certain treatments for obesity.

The federal agency is reviewing requests to cover bariatric surgeries and plans to issue a decision later this year or early next year.

If Medicare, which covers the elderly and disabled, expands coverage of bariatric surgeries, the potential demand will be large, Mr. Encinosa said.

An estimated 395,000 patients ages 65 to 69 will be clinically eligible for the surgeries this year, he said. That number is projected to reach 475,000 by 2010.

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