THURSDAY, Nov. 29, 2018 — Cost and how much they can lose matter more to folks considering weight-loss surgery than recovery time or the risk of complications, a new study finds.

“Instead of asking patients about the reasons for or against particular procedures, we asked patients to tell us what procedure characteristics mattered to them the most,” said study lead author Michael Rozier. He worked on the study while studying health care policy at the University of Michigan.

The results show out-of-pocket costs matter a great deal to patients facing weight-loss (bariatric) surgery, Rozier said in a university news release.

The survey of 800 adults considering obesity surgery also found that the most commonly performed operation, sleeve gastrectomy, doesn’t meet patients’ highest priorities.

With sleeve gastrectomy, a portion of the stomach is removed, leaving a thinner stomach. With a gastric bypass, the stomach is made much smaller and rerouted to bypass part of the small intestine. Patients who have sleeve gastrectomy lose less weight the first year, on average, than patients who have gastric bypass surgery, according to the university research team.

“We know there may be slightly better weight loss and increased comorbidity resolution [more weight-related health issues solved] with bypass, so recommending sleeve gastrectomy may be somewhat different than what patients in this study valued,” said study co-author Dr. Amir Ghaferi, a bariatric surgeon at Michigan Medicine.

The findings can help doctors guide conversations with patients pondering weight-loss surgery, the researchers said.

They noted that even though cost is a main consideration for patients, health care providers are rarely trained to discuss that issue.

“We probably need to figure out an appropriate way to incorporate cost into conversations providers have with their patients,” said Rozier, now an assistant professor of health management and policy at Saint Louis University.

The study was published Nov. 28 in the journal JAMA Surgery.

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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