Obesity/overweight prevalence and economic burdens by bariatric surgery, metabolic syndrome, and related comorbidity in 2013-2019: a nationwide descriptive analysis.

Background: Existing studies are mainly focused on overall obesity or specific subpopulations, while the disease burden among patients with different characteristics of obesity progression remains uncertain.

Objectives: To conduct a descriptive analysis of the contemporary obesity/overweight associated economic burdens stratified by clinically meaningful features associated with obesity.

Settings: Utilizing Taiwan's 2013 National Health Interview Survey and the 2012-2019 National Health Insurance Research Database.

Methods: Six groups of adults with obesity and/or obesity-related conditions were targeted, including people receiving bariatric surgery (BS, n = 1679), having metabolic syndrome (MS, n = 1437), having body mass index (BMI) ≥27/30 kg/m² with obesity-related comorbidities (ORCs, n = 1428/552), and having BMI ≥27/30 kg/m² (n = 3235/1191). Healthcare utilization/expenditures (in 2022 USD) were measured.

Results: In the first year of follow-up, the BS group incurred the highest healthcare expenditures ($3494/person), followed by the MS group ($2852), the BMI ≥30/27 kg/m² with ORCs groups ($2025/$1920), and the BMI ≥30/27 kg/m² groups ($1160/$1032). In the years following BS, the prevalence and treatments for hypertension, diabetes, hyperlipidemia, and sleep apnea decreased significantly, and healthcare expenditures remained the lowest among the 6 groups but increased gradually. Heterogeneity of geographic distribution of obesity prevalence was observed.

Conclusions: Interventions tailored to patient characteristics, especially advanced obesity with high economic burden and obesity-associated geographic disparities, are needed. BS may curtail ORCs/MS, but the gradually increasing expenditures following BS would suggest a need of routine follow-ups.