"Future studies should focus on the potential benefit of improved health and well-being of patients undergoing the procedure rather than on cost savings," Weiner said in a statement.
Allergan Inc., which sells the Lap-Band weight loss device, said Feb. 5 it will sell its obesity-treatment unit in the first half of 2013. The unit's sales tumbled 22 percent in the fourth quarter to $36.8 million. Annual sales are down from a peak of $296 million in 2009 amid questions about the stomach-shrinking device's risk and lawsuits stemming from surgical complications.
More than 500 million people worldwide are obese, according to the World Health Organization. In the U.S., more than 44 percent of adults may be obese by 2030, according to a report from the Trust for America's Health and Robert Wood Johnson Foundation. Obesity-related health costs in the U.S. now top $168 billion annually, the researchers said.
While weight loss surgery can dramatically help a single person, the benefits are markedly less when the risks and costs are considered for everyone getting the procedure, said Edward Livingston, JAMA's deputy managing editor, in an editorial accompanying the study. Swedish research found surgery reduced prescription drug use while boosting hospital costs over time. A U.S. Department of Veterans Affairs analysis found the most common and effective type of bypass surgery failed to reduce health-care spending, he wrote.
"Coupled with findings that bariatric surgery confers little to no long-term survival benefit, these observations show that bariatric surgery does not provide an overall societal benefit," Livingston wrote. "In this era of tight finances and inevitable rationing of health care resources, bariatric surgery should be viewed as an expensive resource that can help some patients."
The surgery should only be offered to those who have clear health problems tied to obesity, such as diabetes or arthritis, and can comply with the dietary restrictions that follow surgery, he said. It shouldn't be done simply to help people lose weight, he said.