Health and economic outcomes of metabolic bariatric surgery: A patient perspective.

Abstract

Objective: Türkiye has the highest obesity prevalence in Europe, contributing to significant health and economic burdens. Metabolic bariatric surgery (MBS) is the most effective intervention for achieving sustained weight loss and improving obesity-related conditions. This study aimed to assess short-term remission rates in six obesity-related conditions and quantify changes in direct medical costs from the patient's perspective at 3 and 6 months following MBS.

Material and methods: This prospective multicentre cohort study included 179 patients aged 18-65 with Class II or higher obesity who underwent MBS between July 2017 and November 2018. Clinical parameters and self-reported direct medical expenditures were evaluated preoperatively and at 3 and 6 months post-operatively. Outcomes included remission or improvement in diabetes, hypercholesterolemia, hypertension, joint diseases, obstructive sleep apnea syndrome (OSAS), and depression, as well as cost reductions.

Results: Mean age was 38.8±11.7 years; 57.5% had been living with obesity for over 25 years. Preoperatively, 82.1% had obesity-related conditions. At 6 months, excess weight loss reached 68.3%. Remission rates were 89.5% for diabetes, 94.6% for hypertension, 85.7% for hypercholesterolemia, and 100% for joint diseases and OSAS. Depression remission was 95.7%. Medication/device use declined by 96%. Total direct medical costs decreased by 13.95%, and by 88.53% excluding surgery.

Conclusion: In a country with high obesity and diabetes rates, MBS offers rapid clinical improvements and substantial cost reductions. Notably, 57% of patients had used non-prescriptive supplements preoperatively, highlighting the need for better health literacy. These findings reinforce the need to prioritize early surgical intervention within national obesity care frameworks.