Pournaras Dimitri J, da Rocha Fernandes João Diogo, Holloway Sara, Marsland Alistair, Tahrani Abd A, Capucci Silvia
Department of Bariatric and Metabolic Surgery, North Bristol NHS Trust, Southmead Hospital, Southmead Road, Bristol, BS10 5NB, UK.
Novo Nordisk A/S, Søborg, Denmark.
Adv Ther. 2025 Jun 18. doi: 10.1007/s12325-025-03267-8.
In this study, we aimed to quantify the economic consequences of limited access to obesity treatment and estimate the effect of modelled weight loss in a population who were eligible for bariatric surgery.
This was a retrospective open cohort study using data from the Discover database (1 January 2010-31 December 2019). Index was the first day that individuals were aged ≥ 18 years and eligible for bariatric surgery [body mass index (BMI) ≥ 40.0 kg/m (obesity class III), or 35.0-39.9 kg/m (obesity class II) and an obesity-related complication]. Time to surgery, healthcare costs and the impact of modelled weight loss over 2 years on estimated healthcare costs were assessed.
In total, 137,184 individuals were eligible for bariatric surgery, of whom 3241 (2.4%) ultimately received surgery during follow-up. Individuals who received surgery were slightly younger, and were more likely to be women and white, than the population eligible for surgery. Overall, 36.6% of individuals underwent surgery ≥ 4 years after they became eligible. Mean annual per-person healthcare costs increased 75% between year 1 and year 8 of the period before surgery in this group [from 1150 British pound sterling (GBP) to 2013 GBP]. Modelled weight loss of 10% would result in 58.3% of eligible individuals transitioning to obesity class I after 2 years, with only 12.2% remaining in obesity class III, resulting in a 14.3% reduction in healthcare costs. Greater degrees of weight loss were associated with greater estimated reductions in BMI and cost.
Delays to prompt weight management support appear to be associated with increasing healthcare costs, which could be mitigated by improving access to weight management.
在本研究中，我们旨在量化肥胖治疗可及性受限的经济后果，并估计在符合减肥手术条件的人群中模拟体重减轻的影响。
这是一项回顾性开放队列研究，使用了来自发现数据库（2010年1月1日至2019年12月31日）的数据。索引是个体年满18岁且符合减肥手术条件的第一天[体重指数（BMI）≥40.0kg/m²（III级肥胖），或35.0 - 39.9kg/m²（II级肥胖）且患有肥胖相关并发症]。评估了手术时间、医疗费用以及模拟的两年体重减轻对估计医疗费用的影响。
共有137184人符合减肥手术条件，其中3241人（2.4%）在随访期间最终接受了手术。接受手术的个体比符合手术条件的人群略年轻，更有可能是女性和白人。总体而言，36.6%的个体在符合条件后≥4年才接受手术。在该组手术前的第1年至第8年期间，人均年医疗费用增加了75%[从1150英镑（GBP）增至2013英镑]。模拟体重减轻10%将导致58.3%的符合条件个体在2年后转变为I级肥胖，只有12.2%仍处于III级肥胖，从而使医疗费用降低14.3%。更大程度的体重减轻与更大程度的BMI估计降低和费用降低相关。
延迟获得及时的体重管理支持似乎与医疗费用增加有关，改善体重管理的可及性可以缓解这一问题。
