Metabolic and bariatric surgery (MBS), 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 treatment.
The objective of this study was to provide the best estimated number of metabolic
and bariatric procedures performed in the United States in 2020.
We reviewed data from the Metabolic and Bariatric Surgery Accreditation and Quality
Improvement Program (MBSAQIP), National Surgical Quality Improvement Program, Bariatric
Outcomes Longitudinal Database, and Nationwide Inpatient Sample. In addition, data
from industry and state databases were used to estimate activity at nonaccredited
centers. Data from 2020 were compared mainly with data from the previous 2 years.
Compared with 2019, the total number of MBS performed in 2020 decreased from approximately
256,000 to 199,000. 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. Single-anastomosis duodeno-ileostomy
was listed for the first time in 2020. Intragastric balloons placement declined from
the previous year.
There was a 22.5% decrease in MBS volume from 2019 to 2020, which coincided with the
COVID-19 pandemic. Sleeve gastrectomy continues to be the dominant procedure, and
for the first time, single-anastomosis duodeno-ileostomy is reported in the MBSAQIP