Weight loss surgery does not reduce long-term health costs – at least among older men, says a new study published in Archives of Surgery. Although bariatric surgery is the most effective way to induce weight loss in individuals who are severely obese, the related health care expenditure trends have not been thoroughly investigated, say the researchers.
They highlight that investigating these trends are important, because as demand for weight loss surgery increases, so does the number of non-white, older and male patients with obesity-related diseases.
In order to compare health care costs three years before and after bariatric procedures, Matthew L. Maciejewski, Ph.D., of the Center for Health Services Research in Primary Care, Durham VA Medical Center, North Carolina, and team examined 847 veterans who underwent weight loss surgery and 847 veterans who did not.
The researchers explained:
“In a propensity-matched cohort of obese, high-risk, primarily male patients, bariatric surgery was not significantly associated with lower health expenditures three years after the procedure.”
According to the researchers, “trends in adjusted total expenditures mirrored the trends of outpatient and inpatient expenditures.”
Results showed that in the 3 years prior to weight loss surgery, adjusted total expenditures were $595 lower for patients, but increased over the six months leading up to the procedures to $28,400, the majority of which was spent on the surgery itself. In addition, patients spent $4,397 in the first six months after the procedure, and this figure remained steady for the next three years.
The authors said:
“These results are notable because they contrast with results from several prior observational studies that found expenditures among post-surgical cases to be lower than those of nonsurgical controls two to four years after the procedures, which can be explained by important differences in the populations examined and the methods of analysis.”
The team highlight that the majority of study participants were male, and their average age was higher than in earlier studies (49.5 years vs. 44-45 years). Furthermore, they state that as the study focused primarily on older, male, sicker patients, it might not be possible to extrapolate from these findings to non-veterans, females, or healthier individuals.
The researchers conclude:
“Although bariatric surgery was not associated with reduced expenditures in this cohort of older predominantly male patients, many patients may still choose to undergo bariatric surgery given the strong evidence of significant reductions in body weight and comorbidities and improved quality of life.
Expenditures may decline further for surgical cases in the longer term, but there were no differences in health expenditures between the surgical and nonsurgical cases during three years of follow-up.”
Written by Grace Rattue