Is weight-loss surgery worth the cost?

Obesity isn't just a serious health issue for more than a third of Americans. It weighs us down financially as well.

An annual $190 billion is spent on obesity-related medical costs, according to a Reuters report, citing data from the Mayo Clinic. In fact, an overweight person is expected to have about $1,850 more in yearly medical costs than someone of healthy weight.

There are even obesity-associated costs to the overall economy. The report says job absenteeism among the obese is higher, airlines need an extra $5 billion in jet fuel to fly heavy passengers compared to 1960 weight data, and we spend an additional $4 billion annually on extra gas for heavy passengers and drivers.

Along with calls for better diets, more exercise and additional research into weight-loss drugs, a lot of hope has been invested over the past two decades in bariatric surgery as a treatment for obesity.

The American Society For Metabolic And Bariatric Surgery calls the medical specialty “the only proven method that results in durable weight loss,” with the potential to treat or even cure a dangerously overweight person of ailments such as diabetes, hypertension, high cholesterol, liver disease and arthritis.

And the popularity of surgical weight-loss procedures has soared. The Los Angeles Times reports the number of bariatric surgeries performed in the United States -- often at a cost of $10,000 to $43,000 per procedure -- is up 16 times from where it was 15 years ago, to about 220,000 annually.

But a new study published by the Journal of the American Medical Association suggests bariatric surgery isn't as efficient as it was expected to be in reducing overall, long-term health care expenses.

The study analyzed information from seven health insurance plans covering more than 18 million people. It compared six years of claims data from those who underwent bariatric surgery to a group who went through related non-surgical treatments.

The study's overall conclusion? "Bariatric surgery does not reduce overall health care costs in the long term,” it says. “Also, there is no evidence that any one type of surgery is more likely to reduce long-term health care costs.”

Some bariatric surgeons are critical of the study, saying the figures would have looked better if the researchers had tracked their patients for longer than six years -- and if they had considered overall cost savings benefits for both employers and insurers regarding reduced disability claims and a drop in absenteeism.

But John Cawley, a Cornell University health economist, liked the study as a way of helping to determine which radical weight-loss treatments are the most medically and economically effective. “We need to know better not just what works,” he told the Times, “but what gets the the best bang for the buck.”