Roux-en-Y Gastric Bypass, Sleeve Gastrectomy Cost-Effective for Teen Obesity

A study published online June 15 in *JAMA Network Open* found that both Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy are cost-effective interventions for adolescents with severe obesity compared to no surgical treatment. The analysis, conducted using a U.S. healthcare perspective, evaluated the economic and clinical outcomes of these bariatric procedures in a simulated cohort of 500 adolescents over a decade. Researchers concluded that both surgeries met standard thresholds for cost-effectiveness, with costs per quality-adjusted life year (QALY) gained below $100,000, a widely accepted benchmark for value in healthcare.

The study modeled outcomes such as BMI reduction, resolution of obesity-related comorbidities like type 2 diabetes, and long-term complications. Both procedures demonstrated significant improvements in health metrics, though sleeve gastrectomy was associated with lower complication rates than RYGB. Cost-effectiveness was consistent across varying assumptions about surgical risks, follow-up costs, and patient adherence. Notably, the analysis highlighted that delaying surgery led to higher cumulative costs due to prolonged management of obesity-related conditions, reinforcing the potential benefits of early intervention.

The findings underscore the role of bariatric surgery as a viable option for adolescents with severe obesity, particularly when conservative measures fail. While the study emphasizes the procedures’ cost-effectiveness, it also notes the importance of comprehensive care, including psychological support and nutritional counseling, to optimize outcomes. The results provide critical evidence for healthcare policymakers and clinicians considering treatment pathways for this population, balancing immediate risks with long-term health and economic benefits.