RYGB, Sleeve Gastrectomy Cost-Effective for Teens With Severe Obesity

Sleeve gastrectomy projected to be the cost-effective strategy at 10 years, with an ICER of $41,164 per QALY gained
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TUESDAY, June 30, 2026 (HealthDay News) -- Both Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy are cost-effective compared with no surgery for adolescents with severe obesity, according to a study published online June 15 in JAMA Network Open.

John B. Rode, M.D., from the Northwestern University Feinberg School of Medicine in Chicago, and colleagues examined the 10-year cost effectiveness of metabolic and bariatric surgery for adolescents with severe obesity using published results from the Teen-Longitudinal Assessment of Bariatric Surgery study. The economic evaluation used a microsimulation model of a cohort of 100,000 simulated adolescents to project the health and cost outcomes of no surgery, RYGB, and sleeve gastrectomy over 10 years.

The researchers projected that sleeve gastrectomy would be the cost-effective strategy at 10 years, with an incremental cost-effectiveness ratio (ICER) of $41,164 per quality adjusted life year (QALY) gained compared with no surgery. The most QALYs were yielded with RYGB, although the ICER was less favorable at $557,751 per QALY gained compared with sleeve gastrectomy. RYGB was estimated to be cost-effective in a direct comparison with no surgery, with an ICER of $50,271 per QALY gained. Sleeve gastrectomy was consistently the cost-effective strategy in sensitivity analyses.

"Our study shows that over time, weight-loss surgery emerges as the most cost-effective option when we consider years of better health that it provides, compared to non-surgical management for teens with severe obesity," Rode said in a statement.

Several authors disclosed ties to the biopharmaceutical and medical device industries.

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