"Someone could come back and say, 'but bariatric surgery improved my life; I was less likely to have a heart attack.' Some studies have shown those kinds of things," Weiner says. But this study didn't address those issues.
"We didn't measure the quality side of the equation," he says. All they looked at was whether the $29,000 cost of the surgery (in 2005 dollars) was made up in lower costs during the ensuing six years. "It does not suggest that the cost for that surgery is made up in savings after the surgery." The cost of the index bariatric procedure was not included in the calculations.
The study's examination of cost data, Weiner says, indicates that patients in the surgical group did lose weight, and did get healthier. But in time, they put weight back on, and costs "may creep back up over time."
Bariatric surgery is performed in about 200,000 patients a year, ostensibly to improve quality of life and reduce risk of heart and metabolic disease. An estimated $168 billion, or 15.5% of the nation's healthcare expenditures, are spent annually to treat obesity and its associated comorbidities.
Weiner says that knowing the surgery doesn't lower healthcare costs can be useful for organizations, public or private payers, or health systems that develop guidelines for providing bariatric surgery. "I don't think it will really impact any doctor or patient for their immediate decision on whether or not they should get surgery. But it does add to our knowledge base of the long-term trade-off of a major medical procedure."