INTRODUCTION The aim of the study was to compare eligible individuals who were or were not treated with bariatric surgery and describe disease burden, treatment, and healthcare costs over 3 years in individuals who were not. METHODS Adults with obesity class II and comorbidities, or obesity class III, were identified in IQVIA Ambulatory EMR - US and PharMetrics® Plus administrative claims databases (January 1, 2007-December 31, 2017). Outcomes included demographics, BMI, comorbidities, and per patient per year (PPPY) healthcare costs. RESULTS Of 127,536 eligible individuals, 3,962 (3.1%) underwent surgery. The surgery group was younger, a greater proportion were women, and mean BMI and rates of some comorbidities (obstructive sleep apnea, gastroesophageal reflux disease, and depression) were higher than in the nonsurgery group. Mean healthcare costs PPPY in the baseline year were USD 13,981 in the surgery group and USD 12,024 in the nonsurgery group. In the nonsurgery group, incident comorbidities increased during follow-up. Mean total costs increased by 20.5% from baseline to year 3, mostly driven by an increase in pharmacy costs; however, fewer than 2% of these individuals initiated antiobesity medications. CONCLUSIONS Individuals who did not undergo bariatric surgery showed a progressive worsening of health and increasing healthcare costs, indicating a large unmet need for access to clinically indicated obesity treatment.

中文翻译：

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未接受减肥手术的严重肥胖者的疾病负担和健康状况：一项回顾性研究。

引言 该研究的目的是比较接受或未接受减肥手术的符合条件的个体，并描述未接受减肥手术的个体 3 年内的疾病负担、治疗和医疗费用。方法 在 IQVIA Ambulatory EMR - US 和 PharMetrics® Plus 行政索赔数据库（2007 年 1 月 1 日至 2017 年 12 月 31 日）中确定患有 II 级肥胖和合并症或 III 级肥胖的成人。结果包括人口统计数据、BMI、合并症和每名患者每年 (PPPY) 医疗费用。结果 在 127,536 名符合条件的个人中，3,962 名 (3.1%) 接受了手术。手术组更年轻，女性比例更高，平均体重指数和一些合并症（阻塞性睡眠呼吸暂停、胃食管反流病和抑郁症）的发生率高于非手术组。基线年的平均医疗费用 PPPY 手术组为 13,981 美元，非手术组为 12,024 美元。在非手术组中，随访期间并发症发生率有所增加。平均总成本从基线到第 3 年增加了 20.5%，主要是由于药品成本的增加；然而，这些人中只有不到 2% 开始服用抗肥胖药物。结论 未接受减肥手术的个体的健康状况逐渐恶化，医疗费用不断增加，这表明对临床指示的肥胖治疗的需求尚未得到满足。