{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T06:02:58Z","timestamp":1784872978223,"version":"3.55.0"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005639","name":"Universidade De S\u00e3o Paulo","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005639","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["OBES SURG"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction\/Purpose<\/jats:title>\n                    <jats:p>Access to bariatric surgery (BS) remains limited in most countries with public healthcare systems, despite the continued rise in obesity prevalence, and Brazil is no exception. This study aimed to estimate the BS rate among adults with severe obesity who were potentially eligible for the procedure in Brazilian state capitals and the Federal District between 2017 and 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Publicly available national databases were used to obtain the number of performed surgeries and to estimate the eligible population. Severe forms of obesity were defined as body mass index (BMI)\u2009\u2265\u200940\u00a0kg\/m\u00b2 or BMI between 35 and 40\u00a0kg\/m\u00b2 in the presence of diabetes or hypertension. The BS rate was calculated using, as the denominator, the number of adults with severe forms of obesity who reported having no private healthcare insurance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>1,251,075 adults living in the study sites had severe forms of obesity. Of these, 738,430 reported having no private healthcare insurance. Between 2017 and 2023, 8,205 BS were performed on residents who underwent the procedure in their state capital. Overall, only 1% (95% CI 1.09\u20131.14) of eligible individuals underwent BS in the Brazilian Unified Health System (SUS) over the study period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These findings highlight the extremely limited access to surgical treatment for severe forms of obesity in the SUS, despite the country being a global leader in the absolute numbers of BS. Accurate estimates of the number of potential candidates for BS may help identify barriers to treatment which may, in turn, increase the BS rates in Brazil and elsewhere.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11695-026-08720-3","type":"journal-article","created":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T20:25:31Z","timestamp":1778703931000},"page":"3111-3116","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Estimating the Bariatric Surgery Rate in the Potentially Eligible Population within the Brazilian Public Healthcare System, 2017\u20132023"],"prefix":"10.1007","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6194-7615","authenticated-orcid":false,"given":"Luis Roberto","family":"da Silva","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7967-0108","authenticated-orcid":false,"given":"Claudio Makoto","family":"Kanai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9505-6784","authenticated-orcid":false,"given":"Anna Carolina Batista","family":"Dantas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wayner Vieira","family":"de Souza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0898-9285","authenticated-orcid":false,"given":"Denis","family":"Pajecki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9921-9234","authenticated-orcid":false,"given":"Beatriz Helena","family":"Tess","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,13]]},"reference":[{"issue":"5","key":"8720_CR1","doi-asserted-by":"publisher","first-page":"1764","DOI":"10.1007\/s11695-024-07196-3","volume":"34","author":"WA Brown","year":"2024","unstructured":"Brown WA, Liem R, Al-Sabah S, Anvari M, Boza C, Cohen RV, et al. Metabolic bariatric surgery across the IFSO chapters: key insights on the baseline patient demographics, procedure types, and mortality from the eighth IFSO global registry report. Obes Surg. 2024;34(5):1764\u201377. https:\/\/doi.org\/10.1007\/s11695-024-07196-3.","journal-title":"Obes Surg"},{"key":"8720_CR2","unstructured":"Sociedade Brasileira de Cirurgia Bari\u00e1trica e Metab\u00f3lica. Cirurgia bari\u00e1trica foi disponibilizada no ano de 2023 para 0,097% dos brasileiros com obesidade grave. [Internet]. 2024. Available from: https:\/\/sbcbm.org.br\/noticias\/cirurgia-bariatrica-foi-disponibilizada-no-ano-de-2023-para-0097-dos-brasileiros-com-obesidade-grave\/ [cited Sept. 16, 2025]."},{"issue":"117","key":"8720_CR3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.11606\/s1518-8787.2022056004133","volume":"56","author":"IA Cecilio e Silva","year":"2022","unstructured":"Cecilio e Silva IA, Favoretto CK, Russo LX. Factors associated with bariatric surgery rates in federative units in Brazil. Rev Saude Publica. 2022;56(117):1\u201312. https:\/\/doi.org\/10.11606\/s1518-8787.2022056004133.","journal-title":"Rev Saude Publica"},{"key":"8720_CR4","doi-asserted-by":"publisher","DOI":"10.1590\/0100-6991e-20223335-en","volume":"49","author":"VDS Oliveira","year":"2022","unstructured":"Oliveira VDS, Chaves VB, Aboud AAN, Bunholli AM, Macedo RM, Pinto RM. Trends in bariatric surgeries in the Brazilian Federative Units, 2009\u20132019: a descriptive study. Rev Col Bras Cir. 2022;49:e20223335. https:\/\/doi.org\/10.1590\/0100-6991e-20223335-en.","journal-title":"Rev Col Bras Cir"},{"key":"8720_CR5","unstructured":"Brasil. Minist\u00e9rio da Sa\u00fade. Departamento de Inform\u00e1tica do SUS. SIHSUS - Sistema de Informa\u00e7\u00f5es Hospitalares do SUS. Bras\u00edlia: Minist\u00e9rio da Sa\u00fade; 2025. 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The funding agency had no role in the conception, design, analysis, or interpretation of the study, nor in the writing of the manuscript.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Financial Support"}}]}}