Nav: Home

Is bariatric surgery a cost-effective treatment for teens with severe obesity?

October 26, 2016

In a study published online by JAMA Surgery, Chin Hur, M.D., M.P.H., of Massachusetts General Hospital, Boston, and colleagues assessed the cost-effectiveness of bariatric surgery for adolescents with obesity using recently published results from the Teen-Longitudinal Assessment of Bariatric Surgery study.

Severe obesity affects 4 percent to 6 percent of U.S. youth and is growing more prevalent. Behavioral intervention is the first-line treatment for adolescents with severe obesity, but this type of intervention rarely leads to meaningful long-term weight loss in this population. Bariatric surgery is increasingly being considered as an option for adolescents who have not achieved adequate weight loss through nonsurgical therapy, but data on cost-effectiveness are limited.

For this study, a model was created to compare 2 strategies: no surgery and bariatric surgery. In the no surgery strategy, patients remained at their initial body mass index (BMI) over time. In the bariatric surgery strategy, patients were subjected to risks of perioperative mortality and complications as well as initial morbidity but also experienced longer-term quality-of-life improvements associated with weight loss. Demographic information of 228 patients included in the analysis: average age, 17 years; average BMI, 53; and 171 (75 percent) were female-surgery-related outcomes. A willingness-to-pay threshold of $100,000 per quality-adjusted life-years was used to assess cost-effectiveness.

The researchers found that while bariatric surgery was not cost-effective over a 3-year time horizon, it could become cost-effective if assessed over a time horizon of 5 years.

"At present, bariatric surgery is performed in approximately 1,000 adolescents per year. Increasing access to bariatric surgery in adolescents, even by a factor of 4, would hardly affect obesity prevalence on a population level. For this reason, experts in childhood and adolescent obesity focus primarily on public health interventions, such as taxes on sugar-sweetened beverages, calorie labeling on restaurant menus, and nutrition standards for food in schools," the authors write.

"From an individual-patient perspective, though, bariatric surgery can result in life-altering weight loss, which not only leads to the resolution and prevention of disease but also allows patients to avoid the stigma, bullying, and isolation that often accompany severe obesity. As evidence supporting the safety and efficacy of bariatric surgery continues to accrue for the adolescent population, it will likely become a more accepted and commonly used therapeutic option. Our analysis indicates that it can also be cost-effective when assessed over a relatively short time horizon. Longer-term studies that track quality of life, weight loss, comorbidity resolution, and health care costs are needed to confirm our findings."

(JAMA Surgery. Published online October 26, 2016.doi:10.1001/jamasurg.2016.3640. This study is available pre-embargo at the For The Media website.)
-end-
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Related material: Available at the For the Media website, the commentary "Our Role in the Battle Against Adolescent Obesity," by William T. Adamson, M.D., of the University of North Carolina School of Medicine, Chapel Hill.

To place an electronic embedded link to this study in your story: This link will be live at the embargo time: http://jamanetwork.com/journals/jamasurgery/fullarticle/10.1001/jamasurg.2016.3640

The JAMA Network Journals

Related Obesity Articles:

Changing the debate around obesity
The UK's National Health Service (NHS) needs to do more to address the ingrained stigma and discrimination faced by people with obesity, says a leading health psychologist.
Study links longer exposure to obesity and earlier development of obesity to increased risk of type 2 diabetes
Cumulative exposure to obesity could be at least as important as actually being obese in terms of risk of developing type 2 diabetes (T2D), concludes new research published in Diabetologia (the journal of the European Association for the Study of Diabetes [EASD]).
How much do obesity and addictions overlap?
A large analysis of personality studies has found that people with obesity behave somewhat like people with addictions to alcohol or drugs.
Should obesity be recognized as a disease?
With obesity now affecting almost a third (29%) of the population in England, and expected to rise to 35% by 2030, should we now recognize it as a disease?
Is obesity associated with risk of pediatric MS?
A single-center study of 453 children in Germany with multiple sclerosis (MS) investigated the association of obesity with pediatric MS risk and with the response of first-line therapy in children with MS.
Women with obesity prior to conception are more likely to have children with obesity
A systematic review and meta-analysis identified significantly increased odds of child obesity when mothers have obesity before conception, according to a study published June 11, 2019 in the open-access journal PLOS Medicine by Nicola Heslehurst of Newcastle University in the UK, and colleagues.
Obesity medicine association announces major updates to its adult obesity algorithm
The Obesity Medicine Association (OMA) announced the immediate availability of the 2019 OMA Adult Obesity Algorithm, with new information for clinicians including the relationship between Obesity and Cardiovascular Disease, Diabetes Mellitus, Dyslipidemia, and Cancer; information on investigational Anti-Obesity Pharmacotherapy; treatments for Lipodystrophy; and Pharmacokinetics and Obesity.
Systematic review shows risk of a child developing overweight or obesity is more than trebled by maternal obesity prior to pregnancy
New research presented at this year's European Congress on Obesity (ECO) in Glasgow, Scotland (April 28- May 1) reveals that the risk of a child becoming overweight or obese is more than trebled by maternal obesity prior to getting pregnant.
Eating later in the day may be associated with obesity
Eating later in the day may contribute to weight gain, according to a new study to be presented Saturday at ENDO 2019, the Endocrine Society's annual meeting in New Orleans, La.
How obesity affects vitamin D metabolism
A new Journal of Bone and Mineral Research study confirms that vitamin D supplementation is less effective in the presence of obesity, and it uncovers a biological mechanism to explain this observation.
More Obesity News and Obesity Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Listen Again: Meditations on Loneliness
Original broadcast date: April 24, 2020. We're a social species now living in isolation. But loneliness was a problem well before this era of social distancing. This hour, TED speakers explore how we can live and make peace with loneliness. Guests on the show include author and illustrator Jonny Sun, psychologist Susan Pinker, architect Grace Kim, and writer Suleika Jaouad.
Now Playing: Science for the People

#565 The Great Wide Indoors
We're all spending a bit more time indoors this summer than we probably figured. But did you ever stop to think about why the places we live and work as designed the way they are? And how they could be designed better? We're talking with Emily Anthes about her new book "The Great Indoors: The Surprising Science of how Buildings Shape our Behavior, Health and Happiness".
Now Playing: Radiolab

The Third. A TED Talk.
Jad gives a TED talk about his life as a journalist and how Radiolab has evolved over the years. Here's how TED described it:How do you end a story? Host of Radiolab Jad Abumrad tells how his search for an answer led him home to the mountains of Tennessee, where he met an unexpected teacher: Dolly Parton.Jad Nicholas Abumrad is a Lebanese-American radio host, composer and producer. He is the founder of the syndicated public radio program Radiolab, which is broadcast on over 600 radio stations nationwide and is downloaded more than 120 million times a year as a podcast. He also created More Perfect, a podcast that tells the stories behind the Supreme Court's most famous decisions. And most recently, Dolly Parton's America, a nine-episode podcast exploring the life and times of the iconic country music star. Abumrad has received three Peabody Awards and was named a MacArthur Fellow in 2011.