Incremental Net Monetary Benefit of Bariatric Surgery: Systematic Review and Meta-Analysis of Cost-Effectiveness Evidences

Noparatayaporn, Prapaporn; Thavorncharoensap, Montarat; Chaikledkaew, Usa; Bagepally, Bhavani Shankara; Thakkinstian, Ammarin

doi:10.1007/s11695-021-05415-9

Cited by 31 publications

(12 citation statements)

References 63 publications

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“…Bariatric surgery is highly effective for weight loss in patients with severe obesity, and it may be associated with long-term cost savings. 7,76 For example, the results of a systematic review and meta-analysis of pooled data from bariatric surgery cost-utility research published through July 2019 in high-income countries (including the United States) found that despite high variability of study results, bariatric surgery can be cost-effective vs usual care (ie, pharmacotherapy and/or lifestyle intervention) over 10 years and over a lifetime horizon. 76 Unfortunately, there is a dearth of similar studies modeling the long-term cost impact of bariatric surgery on the US health care system, specifically.…”

Section: Potential Health Care Costs Savings With Obesity Treatmentsmentioning

confidence: 99%

Increasing clinical awareness of obesity as a serious, chronic, relapsing, and treatable disease

2022

Am J Manag Care

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Section: Potential Health Care Costs Savings With Obesity Treatmentsmentioning

confidence: 99%

Increasing clinical awareness of obesity as a serious, chronic, relapsing, and treatable disease

2022

Am J Manag Care

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“…Finally, BS appears to be cost-effective, compared to the usual non-surgical therapy for obesity and the related chronic diseases, in terms of drugs, hospitalization, and work days lost, at least in high-income countries [85].…”

Section: Bariatric Surgerymentioning

confidence: 99%

Nutritional Management in Bariatric Surgery Patients

Deledda

Pintus²,

Loviselli

et al. 2021

IJERPH

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The obesity epidemic, mainly due to lifestyle changes in recent decades, leads to serious comorbidities that reduce life expectancy. This situation is affecting the health policies of many nations around the world. Traditional measures such as diet, physical activity, and drugs are often not enough to achieve weight loss goals and to maintain the results over time. Bariatric surgery (BS) includes various techniques, which favor rapid and sustained weight loss. BS is a useful and, in most cases, the best treatment in severe and complicated obesity. In addition, it has a greater benefit/risk ratio than non-surgical traditional therapies. BS can allow the obese patient to lose weight quickly compared with traditional lifestyle changes, and with a greater probability of maintaining the results. Moreover, BS promotes improvements in metabolic parameters, even diabetes remission, and in the quality of life. These changes can lead to an increase of life expectancy by over 6 years on average. The nutrition of people before and after BS must be the subject of indications from a trained staff, and patients must be followed in the subsequent years to reduce the risk of malnutrition and the associated problems. In particular, it is still debated whether it is necessary to lose weight prior to surgery, a procedure that can facilitate the surgeon’s work reducing the surgical risk, but at the same time, lengthens preparation times increasing the risks associated with concomitant pathologies. Furthermore, preventing nutritional deficiencies prior to the intervention can improve the results and reduce short- and long-term mortality.

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“…Even modest weight loss of 5% to 10% can help patients prevent and control weight-related conditions, such as type 2 diabetes . Multiple cost-effective weight management treatments (WMT) can support 5% or greater weight loss, including nutrition counseling, medically supervised dietary interventions (eg, very low-calorie meal replacement), oral AOM (phentermine/topiramate, bupropion/naltrexone, or orlistat), and bariatric surgery . However, less than 5% of eligible individuals receive these WMT, and little is known about their clinical potential to support weight loss among individual patients and populations.…”

Section: Introductionmentioning

confidence: 99%

Weight Loss Treatment and Longitudinal Weight Change Among Primary Care Patients With Obesity

Henderson,

Ehlers,

Lee

et al. 2024

JAMA Netw Open

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ImportanceAmong individuals with obesity, 5% or greater weight loss can improve health. Weight management treatments (WMT) include nutrition counseling, very low-calorie meal replacement (MR), antiobesity medications (AOM), and bariatric surgery; however, little is known about how these WMT are associated with weight change among individual patients and populations.ObjectiveTo characterize weight status and WMT use among primary care patients and assess associations between WMT and weight trajectories.Design, Setting, and ParticipantsRetrospective, population-based cohort study of primary care patients from 1 academic health system in Michigan between October 2015 and March 2020 using cross-sectional analysis to compare obesity prevalence and WMT utilization. For patients with obesity and WMT exposure or matched controls, a multistate Markov model assessing associations between WMT and longitudinal weight status trajectories was used. Data were analyzed from October 2021 to October 2023.ExposuresCross-sectional exposure was year: 2017 or 2019. Trajectory analysis exposures were WMT: nutrition counseling, MR, AOM, and bariatric surgery.Main Outcomes and MeasuresCross-sectional analysis compared mean body mass index (BMI), obesity prevalence, and, among patients with obesity, prospective WMT use. The trajectory analysis examined longitudinal weight status using thresholds of ±5% and 10% of baseline weight with primary outcomes being the 1-year probabilities of 5% or greater weight loss for each WMT.ResultsAdult patients (146 959 participants) consisted of 83 636 female participants (56.9%); 8940 (6.1%) were Asian, 14 560 (9.9%) were Black, and 116 664 (79.4%) were White. Patients had a mean (SD) age of 49.6 (17.7) years and mean (SD) BMI of 29.2 (7.2). Among 138 682 patients, prevalence of obesity increased from 39.2% in 2017 to 40.7% in 2019; WMT use among patients with obesity increased from 5.3% to 7.1% (difference: 1.7%; 95% CI, 1.3%-2.2%). In a multistate model (10 180 patients; 33 549 patient-years), the 1-year probability of 5% or greater weight loss without WMT exposure was 15.6% (95% CI, 14.3%-16.5%) at reference covariates. In contrast, the probability of 5% or greater weight loss was more likely with year-long exposures to any WMT (nutrition counseling: 23.1%; 95% CI, 21.3%-25.1%; MR: 54.6%; 95% CI, 46.5%-61.2%; AOM: 27.8%; 95% CI, 25.0%-30.5%; bariatric surgery: 93.0%; 95% CI, 89.7%-95.0%).Conclusions and RelevanceIn this cohort study of primary-care patients with obesity, all WMT increased the patient-level probability of achieving 5% or greater weight loss, but current rates of utilization are low and insufficient to reduce weight at the population level.

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Incremental Net Monetary Benefit of Bariatric Surgery: Systematic Review and Meta-Analysis of Cost-Effectiveness Evidences

Cited by 31 publications

References 63 publications

Increasing clinical awareness of obesity as a serious, chronic, relapsing, and treatable disease

Increasing clinical awareness of obesity as a serious, chronic, relapsing, and treatable disease

Nutritional Management in Bariatric Surgery Patients

Weight Loss Treatment and Longitudinal Weight Change Among Primary Care Patients With Obesity

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