Surgical endoscopy · 2026
Distribution of adult certified bariatric surgery centers in the United States: are we meeting the needs of the people?
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Rosenberg Meagan, Perez Coulter Aixa, Mixer Madison, Romanelli John, Tirabassi Michael V
Аннотация
INTRODUCTION: Obesity-related mortality continues to rise, with adult obesity prevalence at 38% as of 2023. The objective of this study was to determine whether the geographic distribution of certified bariatric surgery centers aligns with state-level obesity prevalence and to identify potentially underserved states.
METHODS: Certified bariatric surgery centers were identified using the American College of Surgeons Surgical Quality Partners database and aggregated by state, including the District of Columbia. State-level obesity prevalence data, defined as body mass index (BMI) > 30, were obtained from the Centers for Disease Control and Prevention, and population estimates were derived from concordant U.S. Census data. Center density was calculated as the number of certified centers per 100,000 obese adults. Using the median center density score, the standard deviation (SD) of each state from the median was calculated to identify states with high- and low-center saturation.
RESULTS: The number of centers per state ranged from 1 (VT, WY) to 92 (TX), with a median of 12 and interquartile range (IQR) of 4.75-21.5. Mean (SD) national obesity prevalence was 33.7% (4.2%). The median center density was 1.05 per 100,000 obese adults. Oklahoma had the lowest density (0.5), placing it 1.82 SDs below the median. Delaware had the highest density (2.34), placing it 4.26 SDs above the median (Fig. 1). Nine states (17.6%) were > 1 SD below the median and included states with high obesity prevalence rankings (West Virginia-1st; Arizona-4th) and low rankings (Vermont-45th;Nevada-38th). Nine states were > 1 SD above the median. The highest obesity rankings in this cohort were South Dakota (13th) and Delaware (18th) while the lowest were D.C (51st) and Massachusetts (48th) (Fig. 2).
CONCLUSIONS: The distribution of certified bariatric surgery centers varies widely by state and does not consistently align with obesity prevalence. Several states appear underserved, while others may be overserved, highlighting geographic disparities in access to bariatric care.
METHODS: Certified bariatric surgery centers were identified using the American College of Surgeons Surgical Quality Partners database and aggregated by state, including the District of Columbia. State-level obesity prevalence data, defined as body mass index (BMI) > 30, were obtained from the Centers for Disease Control and Prevention, and population estimates were derived from concordant U.S. Census data. Center density was calculated as the number of certified centers per 100,000 obese adults. Using the median center density score, the standard deviation (SD) of each state from the median was calculated to identify states with high- and low-center saturation.
RESULTS: The number of centers per state ranged from 1 (VT, WY) to 92 (TX), with a median of 12 and interquartile range (IQR) of 4.75-21.5. Mean (SD) national obesity prevalence was 33.7% (4.2%). The median center density was 1.05 per 100,000 obese adults. Oklahoma had the lowest density (0.5), placing it 1.82 SDs below the median. Delaware had the highest density (2.34), placing it 4.26 SDs above the median (Fig. 1). Nine states (17.6%) were > 1 SD below the median and included states with high obesity prevalence rankings (West Virginia-1st; Arizona-4th) and low rankings (Vermont-45th;Nevada-38th). Nine states were > 1 SD above the median. The highest obesity rankings in this cohort were South Dakota (13th) and Delaware (18th) while the lowest were D.C (51st) and Massachusetts (48th) (Fig. 2).
CONCLUSIONS: The distribution of certified bariatric surgery centers varies widely by state and does not consistently align with obesity prevalence. Several states appear underserved, while others may be overserved, highlighting geographic disparities in access to bariatric care.