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Updated 10:00 AM January 30, 2006




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National rates for bariatric surgery on the rise, especially among youth

As the national rate of obesity steadily has increased across all age groups, so has Americas willingness to turn to an effective surgical intervention to address severe obesity.

From 1996-2002 the use of bariatric surgery has increased seven-fold nationally, and its use has more than tripled among youth. More than 80 percent of individuals in all age groups who underwent the procedure were female.

These findings, from researchers at the U-M Health System, also reveal that in 2002 alone hospitals charged more than $2 billion for bariatric surgery, with private insurers picking up more than 80 percent of the charges.

Results from the study, which also examined the most common medical conditions among youth who undergo bariatric surgery, were reported in the January issue of Archives of Surgery.

Bariatric surgery, which includes procedures such as gastric bypass, gastric banding and biliopancreatic diversion, aims to change the gastrointestinal tract to restrict the amount of food a person is able to consume.

The procedure is recommended only for individuals with severe obesity, or for those who are obese and suffering from other medical complications of obesity such as diabetes.

"The greatest increase in bariatric surgery rates has occurred among non-elderly adults, and, for the first time, we've seen that bariatric surgery rates have increased among the nation's youth, more than three-fold from 1996-2002," says study lead author Dr. Matthew Davis, an assistant professor of pediatrics, internal medicine and public policy in the Child Health Evaluation and Research Unit at C.S. Mott Children's Hospital's Division of General Pediatrics.

Davis says key aspects of this national trend remained unclear and require closer examination. These factors include, the female to male ratio among patients undergoing the procedure in various age groups, additional medical conditions patients may have beyond obesity, and the economic implications of the procedure—however, remained unclear and require closer examination.

Using data from the Nationwide Inpatient Sample (NIS), a database of discharge information developed by federal and state governments and health care institutions, Davis and his colleagues analyzed the most recent data available, 1996-2002, to examine trends in the use of bariatric surgery.

Nationally, the study revealed that rates of bariatric surgery climbed seven-fold from 1996-2002, with increases in all age groups studied: youth (younger than 20 years of age), non-elderly (20-65) and elderly (older than age 65).

The increase is having a noticeable impact on health insurance. In 2002 hospitals charged more than $2 billion for these procedures, with more than 80 percent billed to private insurers. On average, each hospital stay in 2002 for bariatric surgery led to about $29,000 in charges.

"Private payers are shouldering an increased share of the costs for bariatric surgery, and this trend is most likely a result of increased coverage among private payers for this procedure, which has a track record of success compared to other therapies for obesity," Davis says, adding the surgery appears to be an increasingly attractive option for private insurance plans and employers who face growing health care costs associated with obesity.

While the greatest increase in bariatric surgery rates occurred among non-elderly adults, Davis says this is the first study of its kind to report that bariatric surgery rates also have grown among America's youth, with bariatric procedures in this age group more than tripling during the time period studied.

Gender-related findings among the youth population also mirrored those of the non-elderly group in the study. In both age groups, women were four times more likely to undergo bariatric surgery than men.

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