Mixed
Metabolic/bariatric surgery (MBS) is the most cost-effective intervention for class II and III obesity, often demonstrating dominance (cost-saving) over non-surgical management.
For individuals with Class II or III obesity, metabolic/bariatric surgery is the most economically and clinically effective long-term solution, often paying for itself through reduced healthcare costs from comorbidity remission. It should be prioritized over pharmacotherapy for this group.
MBS offers the most durable weight loss, generally 25–30%, along with improvements in survival and quality of life. Economic evaluations consistently report MBS as highly cost-effective—and in some cases cost-saving—especially for class II and III obesity.
Why this rating
Based on multiple economic modeling studies (lifetime, 20-year) across different countries (US, UK, Korea).
Source
Cost-Effectiveness of Obesity Treatments: Glucagon-Like Peptide-1 Receptor Agonists, Endoscopic Sleeve Gastroplasty, and Metabolic/Bariatric Surgery
Yeon‐Ju Huh · Journal of Metabolic and Bariatric Surgery · 2025
DOI 10.17476/jmbs.2025.14.2.97
More from this paper
- Endoscopic Sleeve Gastroplasty (ESG) is a highly cost-effective, less invasive alternative to surgery for Class I obesity, with an ICER well below willingness-to-pay thresholds.Good
- GLP-1 receptor agonists (GLP-1 RAs) are not cost-effective at current prices, requiring significant price reductions to meet standard willingness-to-pay thresholds.Good
Related findings · Mixed
- Bariatric surgery (VSG and RYGB) is the most effective and sustainable treatment for obesity, producing marked and sustained weight loss that non-surgical interventions cannot match.Strong
- Severely protein-deficient diets (2–3% energy) induce lean body mass loss and metabolic imbalance, whereas adequate protein intake (0.66 g/kg/d minimum) is a prerequisite for maintaining muscle, bone, and physiological function.Strong
- For patients with Class III obesity (BMI >39.9 kg/m2), metabolic bariatric surgery (MBS) is significantly more effective than any currently approved medication, with BilioPancreatic Diversion (BPD) showing the highest estimated weight loss.Strong
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