A cost-benefit simulation model of coverage for bariatric surgery among full-time employees.

Journal Article (Journal Article)


To use a simulation model to estimate the costs and benefits of bariatric surgery among full-time employees.

Study design

Multivariate regression analysis of nationally representative survey data sets to estimate the costs of obesity and a simulation model of the number of years until breakeven under alternate assumptions about the costs and benefits of bariatric surgery.


We used a 2-part model to estimate medical costs of obesity based on the 2000-2001 Medical Expenditure Panel Survey. We estimated work loss with a negative binomial regression based on the 2002 National Health Interview Survey. Using these results, we simulated the expected number of years required for a bariatric surgery procedure to become cost saving.


Nine percent of the full-time US workforce, or 29% of the obese workforce, is eligible for bariatric surgery. Obese workers eligible for bariatric surgery have 5.1 (P < .01) additional days of work loss and USD 2230 (in 2004 dollars) (P < .01) higher annual medical costs than persons of normal weight.


Although the cost implications of bariatric surgery among full-time employees depend on many factors, the simulations reveal that 5 or more years of follow-up are most likely required for these operations to become cost saving unless the employee bears a significant fraction of the total costs of the surgery.

Duke Authors

Cited Authors

  • Finkelstein, EA; Brown, DS

Published Date

  • October 2005

Published In

Volume / Issue

  • 11 / 10

Start / End Page

  • 641 - 646

PubMed ID

  • 16232005

Electronic International Standard Serial Number (EISSN)

  • 1936-2692

International Standard Serial Number (ISSN)

  • 1088-0224


  • eng