title: Trends in bariatric surgery, 2002-2012: do changes parallel the obesity trend?
abstract: BACKGROUND
  It is well documented that bariatric surgery is an effective weight loss intervention, and bariatric procedure rates have increased over time. However, there was a period of plateau in procedure rates in the mid to late 2000s. Recent literature has not identified current trends in procedure rates or associations between bariatric surgery and population factors, such as obesity and diabetes.
  
  
  OBJECTIVE
  The purpose of this study was to determine trends in statewide rates of bariatric operations, obesity, and diabetes over an 11-year period and to determine if population factors are associated with procedure rates.
  
  
  METHODS
  Data from the Agency for Healthcare Research and Quality (AHRQ) Healthcare Cost and Utilization Project (HCUP) State Inpatient Database (SID) were utilized to identify a study sample population of patients who underwent bariatric procedures from 2002-2012.
  
  
  METHODS
  State level population characteristics were obtained from the Behavioral Risk Factor Surveillance System and Census Bureau Data for the 11-year period. Statistical analyses determined rates of surgery, obesity, and diabetes over time, as well as associations between surgery rates and population factors.
  
  
  RESULTS
  From 2002-2012, bariatric procedure rates increased, with an exponential rise in laparoscopic surgical methods. Procedure rates reached a peak value in 2009 and then plateaued. Statewide obesity and diabetes rates increased over time, although there was no association between these population factors and procedure rates. Women had consistently higher rates of bariatric operations.
  
  
  CONCLUSIONS
  Although bariatric procedures are an evidenced-based effective treatment for obesity, procedure rates were not associated with the increasing obesity and diabetes rates in the United States. Further research is needed to identify factors that affect the adoption and diffusion of bariatric operations to increase diffusion of beneficial innovations and improve overall quality of care and health outcomes.
authors.affiliation: Medical University of South Carolina, College of Nursing, Charleston, South Carolina. Electronic address: johnsoem@musc.edu.
authors.forename: Emily E
authors.initials: EE
authors.lastname: Johnson
authors.affiliation: Medical University of South Carolina, Department of Health Leadership and Management, Charleston, South Carolina.
authors.forename: Annie N
authors.initials: AN
authors.lastname: Simpson
authors.affiliation: Medical University of South Carolina, Department of Health Leadership and Management, Charleston, South Carolina.
authors.forename: Jillian B
authors.initials: JB
authors.lastname: Harvey
authors.affiliation: Medical University of South Carolina, College of Medicine, Charleston, South Carolina.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Lockett
authors.affiliation: Medical University of South Carolina, College of Medicine, Charleston, South Carolina.
authors.forename: Karl T
authors.initials: KT
authors.lastname: Byrne
authors.affiliation: Medical University of South Carolina, Department of Health Leadership and Management, Charleston, South Carolina.
authors.forename: Kit N
authors.initials: KN
authors.lastname: Simpson
mesh_terms: D000328:Adult; D000368:Aged; D050110:Bariatric Surgery / Q000639:trends*; D005260:Female; D005544:Forecasting; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D009767:Obesity, Morbid / Q000453:epidemiology / Q000601:surgery*; D011379:Prognosis; D058996:Quality Improvement; D012189:Retrospective Studies; D013022:South Carolina / Q000453:epidemiology
keywords: Bariatric surgery; Change rate; Diffusion