National Trends in Bariatric Surgery, 1996-2002—Invited Critique

The American Society of Bariatric Surgery estimates that 16 200 patients were operated on in 1992, 23 100 patients in 1997, and 63 100 patients in 2002. Membership in the American Society of Bariatric Surgery increased from fewer than 300 in 1996 to more than 1300 by 2002. Davis and colleagues more formally document in their article the growth of bariatric surgery in the United States from 1996 to 2002 by using data from the NIS database, which covers 900 to 1000 hospitals. The rates of growth for patients aged 20 to 65 years increased from 5.8 per 100 000 in 1996 to 37.0 per 100 000 in 2002. Because most bariatric surgeons do not operate on patients older than 65 years or younger than 18 years, it is not surprising that these rates were lower. The authors also document that private payers covered most of the cost of bariatric surgery in the United States, a point not surprising because they cover most of the morbidly obese patients who are younger than 65 years.