States that have the largest percentage of adults with obesity do not provide insurance coverage for bariatric weight-loss surgery, a procedure that shrinks the stomach, according to research released Thursday at a global obesity conference.
Mississippi has the second-highest rate of obesity in the country, behind West Virginia, and ranks 45th in the number of surgeries performed in 2016 of the 50 states and Washington, D.C.. The procedure is not covered by insurance in the state, which ranks 48th in the nation for its economy.
Arkansas and Louisiana rank 35th and 36th in the nation for bariatric procedures. They have the fourth- and fifth-highest obesity rates, respectively, their economies rank 40th and 44th, and neither covers the procedure.
Meanwhile, West Virginia, where insurance covers the surgery, ranks 25th.
Bariatric surgery is a procedure that shrinks the stomach so the patient will lose weight by eating less. It is recommended for people with severe obesity who have not had success losing weight with other methods and have a severe risk for obesity-related health problems including type 2 diabetes, heart attack, stroke, and certain cancers among other health issues.
In 2017, 228,000 bariatric procedures were performed in the U.S., a slight increase from 216,1000 the year before.
An estimated 40 percent of U.S. adults, or 93.3 million people, are obese, according to the Centers for Disease Control and Prevention. Obesity is defined as having a body mass index of 30 or greater. Between 2015 and 2016, every U.S. state had an obesity rate of at least 20 percent.
“None of the states with the five highest obesity rates crack the top 20 in terms of bariatric surgery and all but one are in the bottom 10 in terms of its economic rank,” Dr. Eric J. DeMaria, co-author of the study and chief of the division of general/bariatric surgery at East Carolina University in North Carolina, said in a statement.
“This suggests that those with the greatest need for bariatric surgery, the standard of care for severe obesity, may have the least access and opportunity to receive treatment.”
The District of Columbia ranked first for the most bariatric surgeries, the researchers found, which also ranks 50th in obesity. Insurance covers bariatric surgery in the city. Because D.C. is a city of 68 square miles, comparisons with states can be difficult since it is much smaller and doesn’t include suburban and rural areas.
Delaware, New Jersey, New York and Massachusetts followed D.C. as the top states for the procedure and also had low rates of obesity. Insurance covers the surgery in all of the states.
“Bariatric surgery remains one of the most underutilized treatments in America,” said Dr. Wayne J. English, associate professor of surgery at Vanderbilt University in Nashville and co-author of the research.
“There is a great need to offer universal coverage for bariatric surgery so that treatment for a life-threatening disease is not determined by where you happen to live.”
The study, titled “State variation in obesity, bariatric surgery and economic ranks,” was presented at Obesity Week 2018, an international scientific conference on the prevention and treatment of obesity.
• Laura Kelly can be reached at lkelly@washingtontimes.com.
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