Researchers from LSU's Pennington Biomedical Research Center and collaborating institutions have found that Americans with the highest levels of obesity are undergoing fewer surgical procedures overall, according to a study published on June 9. The procedures include common operations such as knee or hip replacement, hernia surgery, and surgeries involving the breast, prostate, and colon—many of which are performed for cancer.
The study authors say these trends are concerning because rising obesity nationally should lead to more, not less, surgeries for common obesity-related diseases and ailments. The research analyzed more than 11.6 million surgical cases from the American College of Surgeons National Surgical Quality Improvement Program between 2005 and 2022.
Investigators found that patients with higher body mass index or extreme obesity experienced progressively lower representation in surgical care over time. Despite an increased prevalence of extreme obesity in the population, these individuals appear to be undergoing fewer operations each year.
The research team used multinomial logistic regression models adjusted for demographics, health status, and comorbidities to evaluate surgical trends across BMI categories. Results showed that the higher the BMI category, the greater the decline in operative representation over time.
"Understanding and addressing these disparities is increasingly urgent," said Dr. Philip Schauer, director of the Metamor Institute and United Companies Life Insurance Co./Mary Kay and Terrell Brown Chair at Pennington Biomedical. "As obesity prevalence continues to rise, healthcare systems must ensure equitable access to surgical evaluation, treatment, and supportive infrastructure for patients across all BMI categories. Having severe obesity should not exclude someone from getting the surgical care they need, whether it's gallbladder surgery, hernia surgery, or hemorrhoid surgery, for example."
The study also examined trends across several specialties including general surgery, gynecology, cardiac surgery, and thoracic surgery. Declines in surgical representation among higher BMI groups were most pronounced in general surgery and abdominal procedures.
