American Society for Metabolic and Bariatric Surgery 2018 estimate of metabolic and bariatric procedures performed in the United States

Wayne J English; Eric J DeMaria; Matthew M Hutter; Shanu N Kothari; Samer G Mattar; Stacy A Brethauer; John M Morton

doi:10.1016/j.soard.2019.12.022

American Society for Metabolic and Bariatric Surgery 2018 estimate of metabolic and bariatric procedures performed in the United States

Surg Obes Relat Dis. 2020 Apr;16(4):457-463. doi: 10.1016/j.soard.2019.12.022. Epub 2020 Jan 3.

Authors

Wayne J English¹, Eric J DeMaria², Matthew M Hutter³, Shanu N Kothari⁴, Samer G Mattar⁵, Stacy A Brethauer⁶, John M Morton⁷

Affiliations

¹ Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee. Electronic address: wayne.english@vumc.org.
² Department of Surgery, East Carolina University, Brody School of Medicine, Greenville, North Carolina.
³ Department of Surgery, Harvard University, Massachusetts General Hospital, Boston, Massachusetts.
⁴ Department of Surgery, University of South Carolina Greenville, Prisma Health - Greenville Memorial Medical Campus, Greenville, North Carolina.
⁵ Department of Surgery, Swedish Medical Center, Seattle, Washington.
⁶ Department of Surgery, The Ohio State University, Wexner Medical Center, Columbus, Ohio.
⁷ Department of Surgery, Yale School of Medicine, Orchard Medical Center, New Haven, Connecticut.

PMID: 32029370
DOI: 10.1016/j.soard.2019.12.022

Abstract

Background: Metabolic and bariatric surgery, despite being the only effective durable treatment for obesity, remains underused as approximately 1% of all patients who qualify undergo surgery. The American Society for Metabolic and Bariatric Surgery created a Numbers Taskforce to specify annual rate of utilization for obesity treatment interventions and to determine if patients in need are receiving appropriate therapy.

Objectives: The objective of this study was to provide the best estimated number of metabolic and bariatric procedure performed in the United States in 2018.

Setting: United States.

Methods: We reviewed data from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program, National Surgical Quality Improvement Program, Bariatric Outcomes Longitudinal Database, and Nationwide Inpatient Sample. In addition, data from industry and outpatient centers were used to estimate outpatient center activity. Data from 2018 were compared mainly with data from the previous 2 years.

Results: Compared with 2017, the total number of metabolic and bariatric procedures performed in 2018 increased from approximately 228,000 to 252,000. The sleeve gastrectomy continues to be the most common procedure. The gastric bypass procedure trend remained relatively stable and the gastric band procedure trend continued to decline. The percentage of revision procedures and biliopancreatic diversion with duodenal switch procedures increased slightly. Finally, intragastric balloons placement continues as a significant contributor to the cumulative total number of procedures performed but declined from the previous year.

Conclusions: There was a 10.8% increase in the number of metabolic and bariatric procedures performed in 2018, compared with 2017, with an overall increase of approximately 60% since 2011. When taking into account primary procedures only, approximately 1.1% of patients who qualified for metabolic and bariatric surgery were treated with surgery in 2018.

Keywords: 2018; Bariatric surgery; Bariatric surgery procedure trends; Estimated numbers; Numbers task force; Procedure trends.

MeSH terms

Bariatric Surgery*
Biliopancreatic Diversion*
Gastrectomy
Gastric Bypass*
Humans
Obesity, Morbid* / surgery
United States / epidemiology