Comparison of the costs associated with medical and surgical treatment of XXXX .

@entity1 @entity353 @entity28
BACKGROUND: We compared the long-term costs and outcomes of gastric bypass versus medical therapy (very low-calorie diet plus weekly behavioral modification) for @entity28 @entity1 . METHODS: A successful outcome was defined as the loss of at least one third of excess weight that was maintained for the duration of the study. A minimal cost was assigned:  3000 for medical and  24,000 for surgical treatment. A cost per pound of weight lost for all @entity1 successfully monitored was calculated. The Federal Trade Commission recently asked all @entity353 programs to report this cost for @entity1 at least 2 years after therapy. RESULTS: A total of 201 @entity1 entered surgical and 161 entered medical therapy. The surgical group was initially heavier (mean body mass index [kg/m2] +/- SE = 49.3 +/- 0.6 versus 41.2 +/- 0.7, p < 0.01), but each group's lowest mean body mass index was similar (31.8 versus 32.1, respectively). A significantly higher percentage of @entity1 in the surgical versus the medical group were still successful at year 5: 89% versus 21%. The cost per pound lost for medical therapy exceeded the cost of surgical therapy in the sixth posttreatment year (both more than  250/pound). CONCLUSIONS: Surgical treatment appears to be more cost-effective at producing and maintaining @entity353 . It is imperative that long-term follow-up studies be funded to definitely establish this finding.
