- The Washington Times - Saturday, January 13, 2007

The number of morbidly obese Americans undergoing weight-loss surgery has skyrocketed in all age groups since 1998 as the nation’s obesity rate has climbed, a new federal report shows.

More than 121,000 bariatric surgeries — operations designed to control obesity — were performed in the U.S. in 2004, an 800 percent increase from the 13,400 seven years earlier, according to the study by U.S. Agency for Healthcare Research and Quality. The study also showed that deaths from such surgeries have declined sharply since 1998.

“This report shows that more Americans are turning to obesity surgery and that an increasing number of young people are undergoing these procedures,” said Dr. Carolyn M. Clancy, director of AHRQ.

Nearly 350 obesity surgeries were performed on adolescents ages 12 to 17 in 2004. In 1998, the number of minors undergoing such operations was “too small to count,” said Bill Encinosa, a senior economist at AHRQ and the study’s author.

Gastric bypass operations that reduce the size of the stomach and intestines and other types of bariatric surgery are beneficial to both the patients, especially Type 2 diabetics, and insurers.

“Insurers save a lot of money [with bariatric surgery], since they [often] stop paying for diabetes, which can cost $4,000 annually,” he said. The report showed that following successful weight loss from bariatric surgery, “diabetes was completely resolved” in nearly 78 percent of patients.

Extremely obese people, who have failed to lose weight through the traditional methods of diet and exercise, drop 62 percent to 70 percent of excess weight after bariatric surgery. Patients typically have a Body Mass Index of 40 or higher (normal is between 18.5 and 24.9) or are battling a serious obesity-related medical condition.

A Harris Poll last year found that 83 percent of U.S. adults 25 and older were overweight and that 39 percent were obese, up six and nine percentage points from the previous year.

Mr. Encinosa said that gastric bypass surgery accounts for 94 percent of all bariatric procedures performed. In addition to decreasing stomach size, he said, this surgery involves reducing intestinal length by about 30 percent to decrease food absorption.

While the overall hospital cost of bariatric surgery swelled more than eightfold between 1998 and 2004 in the United States — from $147 million to $1.3 billion — because of the huge increase in patients, the per-patient cost of the procedures dropped 5 percent. The average cost three years ago, excluding physician fees, was $10,395.

The drop in cost and a significant decrease in deaths related to such procedures have made doctors more willing to perform the operations.

The death rate associated with obesity surgery, which was nearly 1 percent in 1998 plunged to 0.2 percent in 2004, the research showed. In 2004, 230 patients died in hospital stays involving bariatric surgeries.

Despite all the good news associated with obesity surgery, Mr. Encinosa said there are still problems with complications that can include infections, abdominal hernias, vomiting and diarrhea.

“Now that the death rate is very low, we need to reduce complications,” he said, pointing out that six out of 1,000 patients who develop complications die.

The report showed that obesity surgeries for people 18 to 54 rose 726 percent in the seven-year period. The 103,097 operations performed on patients in that age group in 2004 accounted for 85 percent of all bariatric procedures performed that year.

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