Bariatric Surgery Demonstrates Improved Cost-Effectiveness Among Adolescents With Severe Obesity

Key Takeaways:

• Researchers conducted an economic simulation to assess the long-term cost-effectiveness of metabolic and bariatric surgery (MBS) in treating adolescents with severe obesity.
• Over 10 years, both Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy demonstrated better incremental cost-effectiveness ratios (ICERs) than no surgery.
• Sleeve gastrectomy was the most cost-effective treatment option, supporting prior research on the potential of MBS in disease management.

Approximately 1 in 5 US children have obesity, and this number is expected to double by 2035. MBS is an effective treatment option for weight loss and obesity-related comorbidity management, but evidence regarding its long-term cost-effectiveness among adolescents remains limited.

Researchers conducted an economic analysis of MBS for adolescents with severe obesity using data from the Teen-Longitudinal Assessment of Bariatric Surgery (Teen-LABS) study. In a simulation with 100 000 adolescents, investigators compared health and cost outcomes of no surgery, RYGB, and sleeve gastrectomy over 10 years. Primary outcomes included quality-adjusted life-years (QALYs), care costs, and ICERs.

The Cost-Effectiveness of MBS Among Adolescents With Severe Obesity

The analysis identified sleeve gastrectomy as the most cost-effective surgical option. Over 10 years, sleeve gastrectomy had an ICER of $41 164 per QALY gained compared with no surgery.

When compared with sleeve gastrectomy, RYGB resulted in more QALYs but had a substantially higher ICER of $557 751 per QALY gained. However, RYGB was more cost-effective than no surgery, with an ICER of $50 271 per QALY gained.

Implications for Managed Care

The findings suggest that MBS may be a cost-effective treatment strategy for adolescents with severe obesity compared with no surgery, with sleeve gastrectomy representing the more cost-effective surgical option over a 10-year period.

According to the authors, “These findings complement established clinical evidence of the long-term benefits of MBS, supporting its economic value.”

Reference

Rode JB, Lim F, Jenkins TM, Ryder JR, Inge TH, Hur C. A 10-year cost-effectiveness analysis of metabolic and bariatric surgery in adolescents. JAMA Netw Open. 2026;9(6):e2618648. doi:10.1001/jamanetworkopen.2026.18648