The economic impact of weight regain.
Background. Obesity is well known for being associated with significant economic repercussions. Bariatric surgery is the only evidence-based solution to this problem as well as a cost-effective method of addressing the concern. Numerous authors have calculated the cost effectiveness and cost savings of bariatric surgery; however, to date the economic impact of weight regain as a component of overall cost has not been addressed. Methods. The literature search was conducted to elucidate the direct costs of obesity and primary bariatric surgery, the rate of weight recidivism and surgical revision, and any costs therein. Results. The quoted cost of obesity in Canada was $2.0 billion-$6.7 billion in 2013 CAD. The median percentage of bariatric procedures that fail due to weight gain or insufficient weight loss is 20% (average: 21.1% ± 10.1%, range: 5.2-39, n = 10). Revision of primary surgeries on average ranges from 2.5% to 18.4%, and depending on the procedure accounts for an additional cost between $14,000 and $50,000 USD per patient. Discussion. There was a significant deficit of the literature pertaining to the cost of revision surgery as compared with primary bariatric surgery. As such, the cycle of weight recidivism and bariatric revisions has not as of yet been introduced into any previous cost analysis of bariatric surgery.
Centre for the Advancement of Minimally Invasive Surgery, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada T5H 3V9.
Caroline E
CE
Sheppard
University of Alberta, Edmonton, AB, Canada T6G 2C9.
Erica L W
EL
Lester
University of Alberta, Institute of Health Economics, Edmonton, AB, Canada T5J 3N4.
Anderson W
AW
Chuck
Centre for the Advancement of Minimally Invasive Surgery, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada T5H 3V9.
Daniel W
DW
Birch
Centre for the Advancement of Minimally Invasive Surgery, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada T5H 3V9.
Shahzeer
S
Karmali
Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, 2-590 Edmonton Clinic Health Academy, 11405-87 Avenue NW, Edmonton, AB, Canada T6G 2C9.
Christopher J
CJ
de Gara