Changes in Bariatric Surgery Procedure Use in Michigan, 2006-2013

Bariatric surgery is the most effective therapy available for significant and sustainable weight loss in morbidly obese patients.1,2 As a result of the rising prevalence of obesity, improvements in perioperative safety, and expanded insurance coverage, bariatric surgery utilization has increased in the last decade.3,4 Changes in procedure use over time reflect emerging evidence regarding the comparative safety and effectiveness of available procedures.1,2,5 An understanding of current trends in bariatric procedure utilization is essential to primary care physicians counseling morbidly obese patients considering surgical intervention. Though recent reports have documented increased use of sleeve gastrectomy (SG) in certain populations,4,6 the extent to which this procedure has supplanted other procedures, such as Roux-en-Y gastric bypass (RYGB) or laparoscopic adjustable gastric banding (LAGB), is poorly understood. Moreover, it is unclear if relative utilization differs within clinical subgroups that might be predicted to have better outcomes with a specific procedure. To better understand current trends in bariatric surgery utilization, we examined procedure rates in patients undergoing bariatric surgery in Michigan between 2006 and 2013.