{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T14:55:39Z","timestamp":1791384939073,"version":"4.3.3"},"reference-count":34,"publisher":"Springer Science and Business Media LLC","issue":"10","license":[{"start":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T00:00:00Z","timestamp":1786665600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T00:00:00Z","timestamp":1786665600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["OBES SURG"],"published-print":{"date-parts":[[2026,10]]},"DOI":"10.1007\/s11695-026-08894-w","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T05:19:29Z","timestamp":1786684769000},"page":"5222-5232","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Bariatric Surgery on Medication Costs and Disease Burden in Obesity: A Retrospective Cohort Study"],"prefix":"10.1007","volume":"36","author":[{"given":"Andr\u00e9","family":"Oliveira","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolina","family":"Bulhosa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro","family":"Apol\u00f3nia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margarida","family":"Borges","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo","family":"Lima-da-Costa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugo","family":"Santos-Sousa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Freitas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,14]]},"reference":[{"key":"8894_CR1","unstructured":"World Health Organization [Internet]. Geneva: Obesity and overweight fact sheet [cited 2026 Feb 27]. Available from: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/obesity-and-overweight."},{"issue":"4","key":"8894_CR2","doi-asserted-by":"publisher","first-page":"90","DOI":"10.15406\/aowmc.2020.10.00312","volume":"10","author":"TA Omer","year":"2020","unstructured":"Omer TA. The causes of obesity: an in-depth review. Adv Obes Weight Manag Control. 2020;10(4):90\u20134. https:\/\/doi.org\/10.15406\/aowmc.2020.10.00312.","journal-title":"Adv Obes Weight Manag Control"},{"key":"8894_CR3","unstructured":"World Health Organization [Internet]. Portugal: country overview [cited 2026 Feb 27]. Available from: https:\/\/data.who.int\/countries\/620."},{"issue":"1","key":"8894_CR4","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1186\/s12967-019-1919-y","volume":"17","author":"A De Lorenzo","year":"2019","unstructured":"De Lorenzo A, Gratteri S, Gualtieri P, Cammarano A, Bertucci P, Di Renzo L. Why primary obesity is a disease? J Transl Med. 2019;17(1):169. https:\/\/doi.org\/10.1186\/s12967-019-1919-y.","journal-title":"J Transl Med"},{"key":"8894_CR5","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1016\/j.metabol.2018.11.001","volume":"92","author":"KI Avgerinos","year":"2019","unstructured":"Avgerinos KI, Spyrou N, Mantzoros CS, Dalamaga M. Obesity and cancer risk: Emerging biological mechanisms and perspectives. Metabolism. 2019;92:121\u201335. https:\/\/doi.org\/10.1016\/j.metabol.2018.11.001.","journal-title":"Metabolism"},{"issue":"11","key":"8894_CR6","doi-asserted-by":"publisher","first-page":"3963","DOI":"10.1007\/s11695-024-07370-7","volume":"34","author":"M De Luca","year":"2024","unstructured":"De Luca M, Shikora S, Eisenberg D, Angrisani L, Parmar C, Alqahtani A, et al. Scientific Evidence for the Updated Guidelines on Indications for Metabolic and Bariatric Surgery (IFSO\/ASMBS). Obes Surg. 2024;34(11):3963\u20134096. https:\/\/doi.org\/10.1007\/s11695-024-07370-7.","journal-title":"Obes Surg"},{"issue":"21","key":"8894_CR7","doi-asserted-by":"publisher","first-page":"2240","DOI":"10.1001\/jama.2013.5835","volume":"309","author":"S Ikramuddin","year":"2013","unstructured":"Ikramuddin S, Korner J, Lee WJ, Connett JE, Inabnet WB, Billington CJ, et al. Roux-en-Y gastric bypass vs intensive medical management for the control of type 2 diabetes, hypertension, and hyperlipidemia: the Diabetes Surgery Study randomized clinical trial. JAMA. 2013;309(21):2240\u20139. https:\/\/doi.org\/10.1001\/jama.2013.5835.","journal-title":"JAMA"},{"key":"8894_CR8","volume-title":"Clinical management of obesity","year":"2025","unstructured":"Apovian CM, Aronne L, Barenbaum SR, editors. Clinical management of obesity. 3rd ed. West Islip (NY): Professional Communications Inc.; 2025.","edition":"3"},{"key":"8894_CR9","doi-asserted-by":"publisher","first-page":"1283621","DOI":"10.3389\/fendo.2023.1283621","volume":"14","author":"S Law","year":"2023","unstructured":"Law S, Dong S, Zhou F, Zheng D, Wang C, Dong Z. Bariatric surgery and mental health outcomes: an umbrella review. Front Endocrinol (Lausanne). 2023;14:1283621. https:\/\/doi.org\/10.3389\/fendo.2023.1283621.","journal-title":"Front Endocrinol (Lausanne)"},{"issue":"2","key":"8894_CR10","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1097\/ACI.0000000000000339","volume":"17","author":"E Forno","year":"2017","unstructured":"Forno E, Celed\u00f3n JC. The effect of obesity, weight gain, and weight loss on asthma inception and control. Curr Opin Allergy Clin Immunol. 2017;17(2):123\u201330. https:\/\/doi.org\/10.1097\/ACI.0000000000000339.","journal-title":"Curr Opin Allergy Clin Immunol"},{"issue":"4","key":"8894_CR11","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1381\/096089299765552981","volume":"9","author":"JB Dixon","year":"1999","unstructured":"Dixon JB, Chapman L, O\u2019Brien P. Marked improvement in asthma after Lap-Band surgery for morbid obesity. Obes Surg. 1999;9(4):385\u20139. https:\/\/doi.org\/10.1381\/096089299765552981.","journal-title":"Obes Surg"},{"issue":"3","key":"8894_CR12","doi-asserted-by":"publisher","first-page":"508","DOI":"10.1016\/j.jaci.2011.06.009","volume":"128","author":"AE Dixon","year":"2011","unstructured":"Dixon AE, Pratley RE, Forgione PM, Kaminsky DA, Whittaker-Leclair LA, Griffes LA, et al. Effects of obesity and bariatric surgery on airway hyperresponsiveness, asthma control, and inflammation. J Allergy Clin Immunol. 2011;128(3):508\u201315. . . https:\/\/doi.org\/10.1016\/j.jaci.2011.06.009","journal-title":"J Allergy Clin Immunol"},{"issue":"3","key":"8894_CR13","doi-asserted-by":"publisher","first-page":"782","DOI":"10.1007\/s11695-018-3593-1","volume":"29","author":"R Welbourn","year":"2019","unstructured":"Welbourn R, Hollyman M, Kinsman R, Dixon J, Liem R, Ottosson J, et al. Bariatric surgery worldwide: baseline demographic description and one-year outcomes from the fourth ifso global registry report 2018. Obes Surg. 2019;29(3):782\u201395. https:\/\/doi.org\/10.1007\/s11695-018-3593-1.","journal-title":"Obes Surg"},{"issue":"4","key":"8894_CR14","doi-asserted-by":"publisher","first-page":"1075","DOI":"10.1007\/s11695-024-07118-3","volume":"34","author":"L Angrisani","year":"2024","unstructured":"Angrisani L, Santonicola A, Iovino P, Palma R, Kow L, Prager G, et al. IFSO Worldwide Survey 2020\u20132021: Current Trends for Bariatric and Metabolic Procedures. Obes Surg. 2024;34(4):1075\u201385. https:\/\/doi.org\/10.1007\/s11695-024-07118-3.","journal-title":"Obes Surg"},{"issue":"2","key":"8894_CR15","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1159\/000541781","volume":"18","author":"M Borges","year":"2025","unstructured":"Borges M, Sampaio F, Costa J, Freitas P, Matias Dias C, Gaio V, et al. Burden of Disease and Cost of Illness of Overweight and Obesity in Portugal. Obes Facts. 2025;18(2):107\u201320. https:\/\/doi.org\/10.1159\/000541781.","journal-title":"Obes Facts"},{"issue":"5","key":"8894_CR16","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1001\/jamasurg.2017.5025","volume":"153","author":"AP Courcoulas","year":"2018","unstructured":"Courcoulas AP, King WC, Belle SH, Berk P, Flum DR, Garcia L, et al. Seven-Year Weight Trajectories and Health Outcomes in the Longitudinal Assessment of Bariatric Surgery (LABS) Study. JAMA Surg. 2018;153(5):427\u201334. https:\/\/doi.org\/10.1001\/jamasurg.2017.5025.","journal-title":"JAMA Surg"},{"issue":"3","key":"8894_CR17","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1001\/jama.2017.20897","volume":"319","author":"R Peterli","year":"2018","unstructured":"Peterli R, W\u00f6lnerhanssen BK, Peters T, Vetter D, Kr\u00f6ll D, Borb\u00e9ly Y, et al. Effect of Laparoscopic Sleeve Gastrectomy vs Laparoscopic Roux-en-Y Gastric Bypass on Weight Loss in Patients With Morbid Obesity: The SM-BOSS Randomized Clinical Trial. JAMA. 2018;319(3):255\u201365. https:\/\/doi.org\/10.1001\/jama.2017.20897.","journal-title":"JAMA"},{"issue":"8","key":"8894_CR18","doi-asserted-by":"publisher","first-page":"817","DOI":"10.1001\/jamasurg.2023.0252","volume":"158","author":"JH Kauppila","year":"2023","unstructured":"Kauppila JH, Markar S, Santoni G, Holmberg D, Lagergren J. Temporal Changes in Obesity-Related Medication After Bariatric Surgery vs No Surgery for Obesity. JAMA Surg. 2023;158(8):817\u201323. https:\/\/doi.org\/10.1001\/jamasurg.2023.0252.","journal-title":"JAMA Surg"},{"issue":"6","key":"8894_CR19","doi-asserted-by":"publisher","first-page":"893","DOI":"10.2337\/dc16-0145","volume":"39","author":"RL Batterham","year":"2016","unstructured":"Batterham RL, Cummings DE. Mechanisms of Diabetes Improvement Following Bariatric\/Metabolic Surgery. Diabetes Care. 2016;39(6):893\u2013901. https:\/\/doi.org\/10.2337\/dc16-0145.","journal-title":"Diabetes Care"},{"issue":"7","key":"8894_CR20","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1007\/s11906-020-01049-x","volume":"22","author":"R Samson","year":"2020","unstructured":"Samson R, Ayinapudi K, Le Jemtel TH, Oparil S. Obesity, Hypertension, and Bariatric Surgery. Curr Hypertens Rep. 2020;22(7):46. https:\/\/doi.org\/10.1007\/s11906-020-01049-x.","journal-title":"Curr Hypertens Rep"},{"issue":"9","key":"8894_CR21","doi-asserted-by":"publisher","first-page":"952","DOI":"10.1016\/j.amjmed.2016.02.004","volume":"129","author":"SP Heffron","year":"2016","unstructured":"Heffron SP, Parikh A, Volodarskiy A, Ren-Fielding C, Schwartzbard A, Nicholson J. all. Changes in Lipid Profile of Obese Patients Following Contemporary Bariatric Surgery: A Meta-Analysis. Am J Med. 2016;129(9):952\u20139. https:\/\/doi.org\/10.1016\/j.amjmed.2016.02.004.","journal-title":"Am J Med"},{"key":"8894_CR22","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1016\/j.jad.2024.09.009","volume":"367","author":"X Qi","year":"2024","unstructured":"Qi X, Yang J, Liu L, Hao J, Pan C, Wen Y, et al Socioeconomic inequalities, genetic susceptibility, and risks of depression and anxiety: A large-observational study. J Affect Disord. 2024;367:174\u201383. https:\/\/doi.org\/10.1016\/j.jad.2024.09.009.","journal-title":"J Affect Disord"},{"issue":"4","key":"8894_CR23","doi-asserted-by":"publisher","first-page":"692","DOI":"10.1017\/S003329171900059X","volume":"50","author":"K Ohi","year":"2020","unstructured":"Ohi K, Otowa T, Shimada M, Sasaki T, Tanii H. Shared genetic etiology between anxiety disorders and psychiatric and related intermediate phenotypes. Psychol Med. 2020;50(4):692\u2013704. https:\/\/doi.org\/10.1017\/S003329171900059X.","journal-title":"Psychol Med"},{"key":"8894_CR24","doi-asserted-by":"publisher","first-page":"1347","DOI":"10.1016\/j.jad.2021.08.086","volume":"295","author":"SY Struijs","year":"2021","unstructured":"Struijs SY, de Jong PJ, van der Jeronimus BF, Riese H, Spinhoven P. Psychological risk factors and the course of depression and anxiety disorders: A review of 15 years NESDA research. J Affect Disord. 2021;295:1347\u201359. https:\/\/doi.org\/10.1016\/j.jad.2021.08.086.","journal-title":"J Affect Disord"},{"issue":"8","key":"8894_CR25","doi-asserted-by":"publisher","first-page":"e3458","DOI":"10.1002\/dmrr.3458","volume":"37","author":"HH Loh","year":"2021","unstructured":"Loh HH, Francis B, Lim LL, Lim QH, Yee A, Loh HS. Improvement in mood symptoms after post-bariatric surgery among people with obesity: A systematic review and meta-analysis. Diabetes Metab Res Rev. 2021;37(8):e3458. https:\/\/doi.org\/10.1002\/dmrr.3458.","journal-title":"Diabetes Metab Res Rev"},{"key":"8894_CR26","doi-asserted-by":"publisher","first-page":"886","DOI":"10.1016\/j.jad.2018.12.113","volume":"246","author":"H Gill","year":"2019","unstructured":"Gill H, Kang S, Lee Y, Rosenblat JD, Brietzke E, Zuckerman H, et al. The long-term effect of bariatric surgery on depression and anxiety. J Affect Disord. 2019;246:886\u201394. . https:\/\/doi.org\/10.1016\/j.jad.2018.12.113.","journal-title":"J Affect Disord"},{"issue":"2","key":"8894_CR27","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1001\/jama.2015.18118","volume":"315","author":"AJ Dawes","year":"2016","unstructured":"Dawes AJ, Maggard-Gibbons M, Maher AR, Booth MJ, Miake-Lye I, Beroes JM, et al. Mental Health Conditions Among Patients Seeking and Undergoing Bariatric Surgery: A Meta-analysis. JAMA. 2016;315(2):150\u201363. https:\/\/doi.org\/10.1001\/jama.2015.18118.","journal-title":"JAMA"},{"issue":"8","key":"8894_CR28","doi-asserted-by":"publisher","first-page":"1799","DOI":"10.1002\/oby.20738","volume":"22","author":"JE Mitchell","year":"2014","unstructured":"Mitchell JE, King WC, Chen JY, Devlin MJ, Flum D, Garcia L et al. Course of depressive symptoms and treatment in the longitudinal assessment of bariatric surgery (LABS-2) study. Obes (Silver Spring). 2014;22(8):1799\u2013806. . https:\/\/doi.org\/10.1002\/oby.20738.","journal-title":"Obes (Silver Spring)"},{"issue":"8","key":"8894_CR29","doi-asserted-by":"publisher","first-page":"e13927","DOI":"10.1111\/obr.13927","volume":"26","author":"AJ Budin","year":"2025","unstructured":"Budin AJ, Brown WA, MacCormick AD, Caterson I, Sumithran P. Depressive symptoms at short-, medium-, and long-term follow-up after bariatric surgical procedures: A systematic review and meta-analysis. Obes Rev. 2025;26(8):e13927. https:\/\/doi.org\/10.1111\/obr.13927.","journal-title":"Obes Rev"},{"issue":"3","key":"8894_CR30","doi-asserted-by":"publisher","first-page":"792","DOI":"10.1007\/s11695-021-05855-3","volume":"32","author":"LA McGarrity","year":"2022","unstructured":"McGarrity LA, Terrill AL, Martinez PL, Ibele AR, Morrow EH, Volckmann ET, Smith TW. The Role of Resilience in Psychological Health Among Bariatric Surgery Patients. Obes Surg. 2022;32(3):792\u2013800. https:\/\/doi.org\/10.1007\/s11695-021-05855-3.","journal-title":"Obes Surg"},{"issue":"5","key":"8894_CR31","doi-asserted-by":"publisher","first-page":"1345","DOI":"10.1007\/s11136-025-03906-1","volume":"34","author":"JE van Pyykk\u00f6","year":"2025","unstructured":"Pyykk\u00f6 JE, van Olst N, Gerdes VEA, Almansa J, Acherman YIZ, De Brauw M, et al. Relations between trajectories of weight loss and changes in psychological health over a period of 2 years following bariatric metabolic surgery. Qual Life Res. 2025;34(5):1345\u201361. . https:\/\/doi.org\/10.1007\/s11136-025-03906-1.","journal-title":"Qual Life Res"},{"issue":"1","key":"8894_CR32","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1089\/bari.2014.0001","volume":"9","author":"K Lyons","year":"2014","unstructured":"Lyons K, Meisner BA, Sockalingam S, Cassin SE. Body image after bariatric surgery: a qualitative study. Bariatr Surg Pract Patient Care. 2014;9(1):41\u20139. https:\/\/doi.org\/10.1089\/bari.2014.0001.","journal-title":"Bariatr Surg Pract Patient Care"},{"issue":"2","key":"8894_CR33","doi-asserted-by":"publisher","first-page":"e13527","DOI":"10.1111\/obr.13527","volume":"24","author":"L Xie","year":"2023","unstructured":"Xie L, Chandrasekhar A, DeSantis SM, Almandoz JP, de la Cruz-Mu\u00f1oz N, Messiah SE. Discontinuation and reduction of asthma medications after metabolic and bariatric surgery: A systematic review and meta-analysis. Obes Rev. 2023;24(2):e13527. https:\/\/doi.org\/10.1111\/obr.13527.","journal-title":"Obes Rev"},{"issue":"4","key":"8894_CR34","doi-asserted-by":"publisher","first-page":"537","DOI":"10.2337\/dc24-2046","volume":"48","author":"DC Simonson","year":"2025","unstructured":"Simonson DC, Gourash WF, Arterburn DE, Hu B, Kashyap SR, Cummings DE, et al. Health-Related Quality of Life and Health Utility After Metabolic\/Bariatric Surgery Versus Medical\/Lifestyle Intervention in Individuals With Type 2 Diabetes and Obesity: The ARMMS-T2D Study. Diabetes Care. 2025;48(4):537\u201345. https:\/\/doi.org\/10.2337\/dc24-2046.","journal-title":"Diabetes Care"}],"container-title":["Obesity Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11695-026-08894-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11695-026-08894-w","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11695-026-08894-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T14:19:12Z","timestamp":1791382752000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11695-026-08894-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,14]]},"references-count":34,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["8894"],"URL":"https:\/\/doi.org\/10.1007\/s11695-026-08894-w","relation":{},"ISSN":["0960-8923","1708-0428"],"issn-type":[{"value":"0960-8923","type":"print"},{"value":"1708-0428","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,14]]},"assertion":[{"value":"31 May 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 July 2026","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 August 2026","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 August 2026","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"This study protocol was reviewed and approved by the Institutional Ethics Committee (Ref. CE-443-25; approval date: 21 November 2025). For this type of study, formal informed consent was not required.","order":1,"name":"Ethics","label":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare: A.O. is affiliated with the Faculty of Medicine, University of Porto. C.B., P.A. and M.B. are employees of IQVIA Portugal. M.B. is also a member of the Laborat\u00f3rio de Farmacologia Cl\u00ednica e Terap\u00eautica, Faculdade de Medicina, Universidade de Lisboa. H.S. and E.L.C. are affiliated with the Integrated Responsibility Center for Obesity, S\u00e3o Jo\u00e3o Local Health Unit, Porto, and the Faculty of Medicine, University of Porto. P.F. is affiliated with the Integrated Responsibility Center for Obesity, S\u00e3o Jo\u00e3o Local Health Unit, Porto, the Department of Medicine, Faculty of Medicine, University of Porto, and the I3S \u2013 Institute for Research and Innovation in Health, University of Porto. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.","order":2,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}]}}