Weight-Loss Surgeries Less Common in States With High Obesity Rates

FRIDAY, Nov. 16, 2018 — Americans in states with the highest obesity rates are less likely to have weight-loss surgery, researchers say.


“None of the states with the five highest obesity rates crack the top 20 in terms of bariatric [weight-loss] surgery, and all but one are in the bottom 10 in terms of economic rank,” said study co-author Dr. Eric DeMaria.

“This suggests that those with the greatest need for [weight-loss] surgery — the standard of care for severe obesity — may have the least access and opportunity to receive treatment,” DeMaria added. He is chief of the division of general/bariatric surgery at East Carolina University, in Greenville, N.C.

For example, West Virginia and Mississippi have the two highest obesity rates in the nation, but rank 25th and 45th, respectively, in weight-loss surgery rates. Those states also have two of the worst economies in the nation, the study showed.

Based on their analysis, the study authors concluded that a state’s economy and insurance coverage play a greater role in determining rates of weight-loss surgery than its obesity rate.

The study was presented Thursday at the Obesity Week meeting in Nashville, Tenn. It was hosted by the American Society for Metabolic and Bariatric Surgery (ASMBS) and The Obesity Society.

Alabama, Arkansas and Louisiana followed West Virginia and Mississippi as the states with the highest obesity rates.

The top spot for weight-loss surgery was Washington, D.C., which also had the lowest obesity rate in the nation, the findings showed.

The next four states with the highest rates of weight-loss surgery were Delaware, New Jersey, New York and Massachusetts, which ranked 23rd, 36th, 44th and 49th, respectively, in obesity rates. All of those states cover weight-loss surgery as an essential health benefit under the Affordable Care Act (often called Obamacare).

According to study co-author Dr. Wayne English, “Bariatric surgery remains one of the most underutilized treatments in America, and there is great variability in its application because of barriers to access including insurance coverage, economic conditions and other factors.” English is an associate professor of surgery at Vanderbilt University, in Nashville.

“There is a great need to offer universal coverage for [weight-loss] surgery so that treatment for a life-threatening disease is not determined by where you happen to live,” English said in a news release from the ASMBS.

Research presented at medical meetings should be viewed as preliminary until published in a peer-reviewed journal.

In 2017, over 228,000 bariatric procedures were performed in the United States, which is about 1 percent of Americans eligible for the surgery, the study authors noted.

Eligible adults include those with a body mass index (BMI) of at least 35 with an obesity-related condition such as diabetes, or a BMI of at least 40. BMI is an estimate of body fat based on weight and height.

Close to 40 percent of American adults are obese (93 million), and no state has an obesity rate lower than 20 percent, according to the U.S. Centers for Disease Control and Prevention.

Obesity is associated with an increased risk of many serious health problems, including type 2 diabetes, heart disease, stroke, sleep apnea and certain cancers.

More information

The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has more on weight-loss surgery.

Posted: November 2018

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