Authors' objectives: About 93 million Americans are classified as obese (Obesity Action Coalition, 2014). While the number of obese individuals has remained stable in recent years, obesity continues to be one of the most prevalent public health issues in the U.S. (Ogden, 2014). In June 2012, the American Medical Association officially recognized obesity as a chronic disease, believing it would more effectively address the issue; however, the new classification remains controversial among advocates, policymakers, and the medical community, who feel that such a designation may distance patients from responsibility for their condition (Pollack, 2012). Compounding the problem is the lack of viable treatment alternatives. Success rates from lifestyle modifications alone have been modest at best, and the risk-benefit tradeoffs for weight-loss medications are questionable. Clinical interest in expanding the use of bariatric surgery is therefore justifiably high, but there are uncertainties regarding the relative performance of each type of procedure in specific patient populations (e.g., adult versus pediatric patients, moderately versus severely/moderately obese, etc.). There are also conflicting data on long-term benefit. Earlier findings from retrospective chart review as well as prospective observational study suggested a sustained reduction in all-cause mortality at 7-11 years of follow-up (Adams, 2007; Sjostrom, 2007), but data from a more recently-published study of a cohort of U.S. veterans indicated no mortality benefit at a mean of 6.7 years of follow-up (Maciejewski, 2011). As the Washington State Health Care Authority reviews its coverage policy for bariatric surgery, it is therefore timely to assess the evidence on the clinical benefits and cost-effectiveness of common weight loss procedures across all relevant populations, including those defined by level of obesity, age, and levels of comorbidity.

Project Status: Completed

URL for project: http://www.icer-review.org/bariatric-surgery/

Year Published: 2015

URL for published report: http://www.hca.wa.gov/hta/Documents/bariatric_final_rpt_040315.pdf

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: United States

Organisation Name: Institute for Clinical and Economic Review

Contact Address: 101 Merrimac St., 10th FL., Boston MA, USA 02114, Tel: (617) 724-4445 , Fax: (617) 726-9414

Contact Name: info@icer-review.org

Contact Email: info@icer-review.org

Copyright: Institute for Clinical and Economic Review (ICER)