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Weight-loss surgery increasing, except for the poor

There will be nearly ten times as many operations performed for weight loss in 2005 as there were in 1998, report researchers from the University of Chicago and the University of California at Irvine in the 19 October 2005 issue of JAMA, but the groups that need surgery the most are not the ones driving the increase.

Surgeons performed an estimated 13,365 bariatric procedures, primarily gastric bypass operations, in 1998. In four years that had doubled and doubled again, to 72,177 in 2002. The authors project 102,794 such operations in 2003; 130,000 in 2005 and as many as 218,000 by 2010.

Recent growth, they note, was "substantially higher than that previously reported."

Along with the rapid increase in number of cases there was a slower but substantial shift toward patients who were from wealthier households and with private insurance.

"As surgical treatment for obesity increased, disparities in receipt of bariatric surgery increased with men, those with public insurance, and those residing in lower income areas less likely to undergo surgery over time," said the study's lead author, Heena Santry, M.D., surgical resident at the University of Chicago Hospitals.

"As long as bariatric surgery remains the only durable option for weight loss in the morbidly obese," she said, "we need to make an effort to ensure that all populations who suffer from morbid obesity have the option of surgical weight-loss irrespective of insurance provider or income level."

Morbid obesity, defined as a body mass index of 40 or greater (or 35 with additional medical problems), has become disturbingly common. In 1986, one out of 200 U.S. adults had a BMI of 40 or above. By 2002 that had risen to one out of 20, with even higher rates among those with lower incomes and less education.

The researchers, Santry and colleagues Diane Lauderdale, Ph.D., of the University of Chicago and Daniel Gillen, Ph.D., of UC Irvine, worked with dat
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Contact: John Easton
John.Easton@uchospitals.edu
773-702-6241
University of Chicago Medical Center
18-Oct-2005


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