Researchers at LSU’s Pennington Biomedical Research Center and partner institutions found that Americans with the highest levels of obesity have fewer surgical procedures overall. These surgeries include common surgeries (often performed for cancer) such as knee and hip replacements, hernia surgery, and breast, prostate, and colon surgeries.
The study authors say these trends are concerning, as obesity is on the rise across the country, so surgeries for common obesity-related diseases and conditions should increase, not decrease. “Increasing severity of obesity in the United States is associated with decreased surgical treatment,” the study found. obesityanalyzed more than 11.6 million surgical cases from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) between 2005 and 2022.
Researchers found that patients with a high body mass index (BMI) or those who were extremely obese were less likely to receive surgical treatment over time. Despite the increasing prevalence of extreme obesity, the number of surgeries these people undergo appears to be decreasing over the years.
Obesity is known to be associated with an increased risk of many conditions treated by surgical intervention, so identifying the mechanisms underlying these disparities is critical to ensure that people with high BMI have equitable access to health care.
This study revealed an alarming disconnect between the prevalence of severe obesity and access to surgical treatment for a variety of common surgeries. Although people with the highest BMI levels have the highest burden of obesity-related diseases, they appear to undergo proportionately fewer surgical interventions each year. ”
Dr. Vance Albaugh, Senior Author, Pennington Biomedical and Metamol Research Institute
The research team used multinomial logistic regression models that adjusted for demographics, health status, and comorbidities to assess propensity for surgery across BMI categories. Results showed that the higher the BMI category, the greater the decline in surgical costs over time.
Researchers suggest that this finding may reflect multiple barriers to care, including:
- Increased surgical complexity and perioperative risks
- Limited access to specialized equipment and infrastructure
- Reduced eligibility for elective procedures
- Delays in access to diagnosis and preventive treatment
The authors warn that reduced access to surgical intervention may lead to worse health outcomes and more advanced disease in severely obese patients.
“Understanding and addressing these disparities has become increasingly urgent,” said Philip Schauer, Ph.D., Metamor Institute Director and United Companies Life Insurance Company/Mary Kay, and Terrell Brown, Chairman, Pennington Biomedical. “As the prevalence of obesity continues to rise, health systems must ensure equitable access to surgical evaluation, treatment, and support infrastructure for patients of all BMI categories. Severe obesity should not prevent patients from receiving necessary surgical treatments, such as gallbladder surgery, hernia surgery, and hemorrhoid surgery.”
The study also looked at trends across surgical specialties, including general surgery, gynecology, cardiac surgery, and thoracic surgery. The reduction in surgical procedures in the high BMI group was most significant for general surgery and abdominal surgery.
sauce:
Pennington Biomedical Research Center
Reference magazines:
Kachmar, M. others. (2026). Increasing severity of obesity in the United States is associated with decreased surgical treatment. obesity. DOI: 10.1002/oby.70240. https://onlinelibrary.wiley.com/doi/10.1002/oby.70240
