Why Weight Loss Surgery Could Be a Money Saver

Bariatric surgery may reduce long-term health care costs

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Weight-loss surgery may shrink more than just waistlines.

A new study found that gastric banding and gastric bypass surgery may reduce health care costs tied to obesity and related diseases in the long term.

"Patients with severe obesity have greater health care use rates and higher levels of morbidity/mortality," wrote lead study author Kristina H. Lewis, MD, of Kaiser Permanente in Atlanta, and colleagues. "Thus, it is increasingly important to evaluate the comparative effectiveness of treatments for this condition."

Gastric banding and gastric bypass are two of the most common weight-loss procedures in the US, according to Dr. Lewis and team. A bariatric procedure is an operation on the stomach and/or intestines that helps patients with extreme obesity to lose weight. This weight loss may be achieved by reducing the size of the stomach with a gastric band or by redirecting the small intestine into a small stomach pouch (gastric bypass).

According to the American Society for Metabolic and Bariatric Surgery, bariatric surgery is only for patients who are more than 100 pounds overweight, have at least two obesity-related conditions and who can’t lose weight any other way.

Dr. Lewis and team looked at data on patients ages 18 to 64 who had a weight-loss procedure for the first time between 2005 and 2011. To compare the cost of laparoscopic adjustable gastric banding (AGB) and Roux-en-Y gastric bypass (RYGB), researchers looked at almost 5,000 patients who had each procedure.

Bariatric procedures can lead to dramatic weight loss and reduce health problems related to obesity. However, they can be costly and can result in complications.

Dr. Lewis and team found that both AGB and RYGB patients lowered their drug and overall health care costs within the first three years after surgery.

However, the RYGB patients' number of ER visits, hospital stays and complications shot up in the first two years after surgery. But by year three, those patients had lowered their yearly medical and prescription costs overall — compared with the AGB patients.

"Our finding that both procedures were associated with flattened cost trends among commercially insured patients is novel," Dr. Lewis and colleagues wrote. "Presuming that the [patients] comprising our sample continue on the [paths] demonstrated in the 3 years after their procedures, our analyses suggest both AGB and RYGB might be associated with long-term cost savings ..."

According to Dr. Lewis and team, these findings may help doctors and policymakers compare outcomes and costs before recommending weight-loss procedures.

"This finding implies that bariatric surgery is certainly not increasing costs as many worry about, and it very well may result in net cost savings in the long term," wrote Justin B. Dimick, MD, of the University of Michigan, Ann Arbor, in an editorial about this study.

The study and editorial were published June 3 in JAMA Surgery.

The National Institutes of Health funded this research. Dr. Lewis and team disclosed no conflicts of interest.

Review Date: 
June 4, 2015
Last Updated:
June 8, 2015