Skip to main content

Examining the Rates of Obesity and Bariatric Surgery in the United States



The aim of this study is to evaluate the change in rate of increase of bariatric surgery performed compared to the growth of obesity and severe obesity in the United States (US).

Materials and Methods

The number of primary adult bariatric procedures performed in the US between 2015 and 2018 was obtained from the Metabolic and Bariatric Surgery Accreditation Quality and Improvement Project (MBSAQIP) database. The US Census database was used to derive age-adjusted obesity and severe obesity prevalence among adults. Prevalence of bariatric surgery, by year, was estimated as the ratio of the number of patients undergoing surgery and the projected number of eligible individuals for that year.


There were 627,386 bariatric procedures performed for body mass index (BMI) ≥ 30 kg/m2, of which 73.3% (n = 459,800) were performed for BMI ≥ 40 kg/m2. Although the rate of obesity increased by 3.32% per year during this period (RR = 1.0332 per year increase; 95% CI = 1.0313, 1.0352), the rate of surgery per eligible population increased by only 2.47% (RR = 1.0247 per year increase; 95% CI = 1.0065, 1.0432). The prevalence of severe obesity increased from 7.70% (n = 17,494,910) in 2015 to 9.95% (n = 23,135,039) in 2018 while the prevalence of surgery decreased from 0.588 per 100 eligible population in 2015 to 0.566 per 100 eligible population in 2018.


The rate of utilization has not kept up with the rate of increase in this disease, our costliest illness. There is a strong need to educate the public, healthcare professionals, insurance carriers, and legislators.

Graphical abstract

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2


  1. Aminian A, Andalib A, Khorgami Z, et al. A nationwide safety analysis of bariatric surgery in nonseverely obese patients with type 2 diabetes. Surg Obes Relat Dis. 2016;12(6):1163–70.

    Article  Google Scholar 

  2. English WJ, DeMaria EJ, Hutter MM, et al. American Society for Metabolic and Bariatric Surgery 2018 estimate of metabolic and bariatric procedures performed in the United States. Surg Obes Relat Dis. 2020;16(4):457–63.

    Article  Google Scholar 

  3. Flegal KM, Kruszon-Moran D, Carroll MD, et al. Trends in obesity among adults in the United States, 2005 to 2014. JAMA 2016 315(21):2284

  4. Sood A, Abdollah F, Sammon JD, et al. The effect of body mass index on perioperative outcomes after major surgery: results from the National Surgical Quality Improvement Program (ACS-NSQIP) 2005–2011. World J Surg. 2015;39(10):2376–85.

    Article  Google Scholar 

  5. Zizza C, Herring AH, Stevens J, et al. Length of hospital stays among obese individuals. Am J Public Health. 2004;94(9):1587–91.

    Article  Google Scholar 

  6. Tremmel M, Gerdtham UG, Nilsson PM, et al. Economic burden of obesity: a systematic literature review. Int J Environ Res Public Health. 2017;14(4):435.

    Article  Google Scholar 

  7. Colquitt JL, Pickett K, Loveman E, et al. Surgery for weight loss in adults. Cochrane Database Syst Rev 2014 8: CD003641.

  8. Inge TH, Courcoulas AP, Jenkins TM, et al. Weight loss and health status 3 years after bariatric surgery in adolescents. N Engl J Med. 2016;374(2):113–23.

    CAS  Article  Google Scholar 

  9. Courcoulas AP, King WC, Belle SH, et al. Seven-year weight trajectories and health outcomes in the Longitudinal Assessment of Bariatric Surgery (LABS) study. JAMA Surg. 2018;153(5):427–34.

    Article  Google Scholar 

  10. Hales CM, Carroll MD, Fryar CD, et al. Prevalence of obesity and severe obesity among adults: United States, 2017–2018. NCHS Data Brief, no 360. Hyattsville, MD: National Center for Health Statistics 2020.

  11. Association., American Diabetes, Economic costs of diabetes in the U.S. in 2017. Accessed at on October 22, 2020. , 2018.

  12. Martin M, Beekley A, Kjorstad R, et al. Socioeconomic disparities in eligibility and access to bariatric surgery: a national population-based analysis. Surg Obes Relat Dis. 2010;6(1):8–15.

    Article  Google Scholar 

  13. Mainous AG, Johnson SP, Saxena SK, et al. Inpatient bariatric surgery among eligible black and white men and women in the United States, 1999–2010. Am J Gastroenterol. 2013;108(8):1218–23.

    Article  Google Scholar 

  14. Tork S, Meister KM, Uebele AL, et al. Factors influencing primary care physicians’ referral for bariatric surgery. JSLS J Soc Laparoendosc Surg, 2015. 19(3): e2015.

  15. Ferrante JM, Piasecki AK, Ohman-Strickland PA, et al. Family physicians’ practices and attitudes regarding care of extremely obese patients. Obesity. 2009;17:1710–6.

    Article  Google Scholar 

  16. Funk LM, Jolles S, Fischer LE, et al. Patient and referring practitioner characteristics associated with the likelihood of undergoing bariatric surgery: a systematic review. JAMA Surg. 2015;150(10):999–1005.

    Article  Google Scholar 

  17. ASMBS/ NORC Brief (2016). Obesity Rises to Top Health Concern for Americans, but Misperceptions Persist. Accessed on Aug 10, 2020 at :

  18. ASMBS updated position statement on insurance mandated preoperative weight loss requirements. Surg Obes Relat Dis 2016. 12(5): 955–9.

  19. Angrisani L, Santonicola A, Iovino P, Vitiello A, Higa K, et al. IFSO worldwide survey 2016: primary, endoluminal, and revisional procedures. Obes Surg. 2018;28:3783–94.

    Article  Google Scholar 

  20. Dolan P, Afaneh C, Symer M, et al. Assessment of Public Attitudes Toward Weight Loss Surgery in the United States. JAMA Surg. 2019;154(3):264–6.

    Article  Google Scholar 

  21. Executive Council of ASMBS. Safer through surgery: American Society for Metabolic and Bariatric Surgery statement regarding metabolic and bariatric surgery during the COVID-19 pandemic. Surg Obes Relat Dis. 2020;16(8):981–2.

    Article  Google Scholar 

  22. Adams TD, Davidson LE, Litwin SE, et al. Weight and metabolic outcomes 12 years after gastric bypass. N Engl J Med. 2017;377(12):1143–55.

    Article  Google Scholar 

  23. Zhou X, Yu J, Li L, et al. Effects of bariatric surgery on mortality, cardiovascular events, and cancer outcomes in obese patients: systematic review and meta-analysis. Obes Surg. 2016;26(11):2590–601.

    Article  Google Scholar 

  24. Adams TD, Mehta TS, Davidson LE, et al. All-cause and cause-specific mortality associated with bariatric surgery: a review. Curr Atheroscler Rep. 2015;17(12):74.

    Article  Google Scholar 

  25. Sudan R, Nguyen NT, Hutter MM, et al. Morbidity, mortality, and weight loss outcomes after reoperative bariatric surgery in the USA. J Gastrointest Surg. 2015;19:171–9.

    Article  Google Scholar 

  26. Ingraham AM, Cohen ME, Ko CY, et al. A current profile and assessment of North American cholecystectomy: results from the American College of Surgeons National Surgical Quality Improvement Program. J Am Coll Surg. 2010;211:176–86.

    Article  Google Scholar 

  27. Niebisch S, Fleming FJ, Galey KM, et al. Perioperative risk of laparoscopic fundoplication: safer than previously reported-analysis of the American College of Surgeons National Surgical Quality Improvement Program 2005 to 2009. J Am Coll Surg. 2012;215:61–8.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Maria S. Altieri.

Ethics declarations

Conflict of Interest

The authors declare no competing interests.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Key Points

• The rate of obesity is increasing in the USA

• The rate of utilization of bariatric surgery has not kept up

• There is a need for education of healthcare professionals and public

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Altieri, M.S., Irish, W., Pories, W.J. et al. Examining the Rates of Obesity and Bariatric Surgery in the United States. OBES SURG 31, 4754–4760 (2021).

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:


  • Eligible population
  • Rate of bariatric surgery
  • Rate of obesity