{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T02:48:09Z","timestamp":1788576489448,"version":"build-2803163510"},"reference-count":62,"publisher":"American Medical Association (AMA)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Obesity affects 1 in 5 US children, with the global prevalence projected to double by 2035. Among adolescents with severe obesity, metabolic and bariatric surgery (MBS) yields durable weight loss and comorbidity improvement, although its long-term cost-effectiveness remains uncertain.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To evaluate the 10-year cost-effectiveness of MBS for adolescents with severe obesity using recently published results from the Teen\u2013Longitudinal Assessment of Bariatric Surgery (Teen-LABS) study.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This economic evaluation used a microsimulation model of a cohort of 100\u202f000 simulated adolescents in the US health care sector to project health and cost outcomes of no surgery, Roux-en-Y gastric bypass (RYGB), and sleeve gastrectomy over 10 years among adolescents with severe obesity. Model inputs, including longitudinal clinical performance, were derived from Teen-LABS study data, published literature, and national databases. Data were analyzed from April 2023 to October 2025.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Quality-adjusted life-years (QALYs), costs (2022 US dollars), and incremental cost-effectiveness ratios (ICERs), with future costs and QALYs discounted at 3.0% annually. A willingness-to-pay (WTP) threshold of $100\u202f000 per QALY gained was used to assess cost-effectiveness.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The population was a hypothetical cohort of 100\u202f000 adolescents with the following baseline characteristics: age 17 years, body mass index 52.1, 75.0% female, 13.3% with type 2 diabetes, 4.9% with low ferritin, 37.2% with low vitamin D, and 0.4% with low vitamin B12. At 10 years, sleeve gastrectomy was projected to be the cost-effective strategy, with an ICER of $41\u202f164 per QALY gained when compared with no surgery. RYGB yielded the most QALYs, although with a less favorable ICER of $557\u202f751 per QALY gained compared with sleeve gastrectomy. However, in a direct comparison with no surgery, RYGB was estimated to be cost-effective, with an ICER of $50\u202f271 per QALY gained. In sensitivity analyses, sleeve gastrectomy was consistently the cost-effective strategy.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this economic evaluation of bariatric surgery for adolescents with severe obesity, both RYGB and sleeve gastrectomy were determined to be cost-effective when compared with no surgery. However, sleeve gastrectomy was estimated to be the cost-effective strategy over a 10-year time horizon when simultaneously comparing all 3 interventions. These findings complement established clinical evidence of the long-term benefits of MBS, supporting its economic value.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2026.18648","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T15:30:35Z","timestamp":1781537435000},"page":"e2618648","source":"Crossref","is-referenced-by-count":1,"title":["A 10-Year Cost-Effectiveness Analysis of Metabolic and Bariatric Surgery in Adolescents"],"prefix":"10.1001","volume":"9","author":[{"given":"John B.","family":"Rode","sequence":"first","affiliation":[{"name":"Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois"},{"name":"Ann & Robert H. Lurie Children\u2019s Hospital of Chicago, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Medicine, Columbia University Irving Medical Center, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todd M.","family":"Jenkins","sequence":"additional","affiliation":[{"name":"University of Cincinnati College of Medicine, Cincinnati, Ohio"},{"name":"Department of Pediatrics, Cincinnati Children\u2019s Hospital Medical Center, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin R.","family":"Ryder","sequence":"additional","affiliation":[{"name":"Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois"},{"name":"Ann & Robert H. Lurie Children\u2019s Hospital of Chicago, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas H.","family":"Inge","sequence":"additional","affiliation":[{"name":"Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois"},{"name":"Ann & Robert H. 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