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