Obesity/overweight prevalence and economic burdens by bariatric surgery, metabolic syndrome, and related comorbidity in 2013-2019: a nationwide descriptive analysis

• Published in: Surgery for obesity and related diseases Vol. 21; no. 7; pp. 719 - 730
• Main Authors: Chong, Kah Suan, Yang, Chun-Ting, Chang, Yi-Hsin, Kuo, Shihchen, Chen, Jian-Han, Lee, Chia-Jung (Audrey), Chang, Erin, Chou, Chu-Kuang, Ou, Huang-Tz
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.07.2025
• Subjects: Adult; Bariatric surgery; Bariatric Surgery - economics; Bariatric Surgery - statistics & numerical data; Body Mass Index; Comorbidity; Cost of Illness; Economic; Female; Geographic disparities; Health Expenditures - statistics & numerical data; Humans; Male; Metabolic Syndrome - economics; Metabolic Syndrome - epidemiology; Middle Aged; Obesity; Obesity - economics; Obesity - epidemiology; Obesity - surgery; Overweight - economics; Overweight - epidemiology; Overweight - surgery; Prevalence; Taiwan - epidemiology; Taiwan; Obesity; Geographic disparities; Economic; Prevalence; Bariatric surgery
• DOI: 10.1016/j.soard.2024.12.026
• ISSN: 1550-7289; 1878-7533

Existing studies are mainly focused on overall obesity or specific subpopulations, while the disease burden among patients with different characteristics of obesity progression remains uncertain. To conduct a descriptive analysis of the contemporary obesity/overweight associated economic burdens stratified by clinically meaningful features associated with obesity. Utilizing Taiwan’s 2013 National Health Interview Survey and the 2012-2019 National Health Insurance Research Database. Six groups of adults with obesity and/or obesity-related conditions were targeted, including people receiving bariatric surgery (BS, n = 1679), having metabolic syndrome (MS, n = 1437), having body mass index (BMI) ≥27/30 kg/m2 with obesity-related comorbidities (ORCs, n = 1428/552), and having BMI ≥27/30 kg/m2 (n = 3235/1191). Healthcare utilization/expenditures (in 2022 USD) were measured. In the first year of follow-up, the BS group incurred the highest healthcare expenditures ($3494/person), followed by the MS group ($2852), the BMI ≥30/27 kg/m2 with ORCs groups ($2025/$1920), and the BMI ≥30/27 kg/m2 groups ($1160/$1032). In the years following BS, the prevalence and treatments for hypertension, diabetes, hyperlipidemia, and sleep apnea decreased significantly, and healthcare expenditures remained the lowest among the 6 groups but increased gradually. Heterogeneity of geographic distribution of obesity prevalence was observed. Interventions tailored to patient characteristics, especially advanced obesity with high economic burden and obesity-associated geographic disparities, are needed. BS may curtail ORCs/MS, but the gradually increasing expenditures following BS would suggest a need of routine follow-ups. •High costs in patients with bariatric surgery, and comorbid with chronic diseases.•Decline in chronic diseases and associated treatments after bariatric surgery.•Apparent geographic disparities across populations with different obesity status.