{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T10:19:11Z","timestamp":1785406751084,"version":"3.56.0"},"reference-count":19,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T00:00:00Z","timestamp":1781308800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007414","name":"Qassim University","doi-asserted-by":"publisher","award":["QU-APC-2026"],"award-info":[{"award-number":["QU-APC-2026"]}],"id":[{"id":"10.13039\/501100007414","id-type":"DOI","asserted-by":"publisher"}]},{"award":["QU-APC-2026"],"award-info":[{"award-number":["QU-APC-2026"]}],"id":[{"id":"https:\/\/ror.org\/01wsfe280","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: In the US, obesity is still a serious public health issue. Bariatric surgery utilization has recently been influenced by the COVID-19 pandemic and the 2022 American Society for Metabolic and Bariatric Surgery (ASMBS)\/International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) guideline expansion. The combined effects of these events on national utilization trends remain unclear. Methods: We conducted a retrospective longitudinal study using electronic medical record data from the TriNetX network, including adults aged \u226518 years from 2018 through 2024. Primary bariatric procedures were identified using validated CPT and ICD codes. Quarterly surgery rates per 100,000 adults were calculated using the number of unique adults with at least one healthcare encounter per quarter as the denominator. Level and slope changes related to the start of COVID-19 (Q2 2020) and the application of the 2022 ASMBS guidelines (Q1 2022) were evaluated using interrupted time series models. Procedure-type distributions were also evaluated. Results: A total of 215,072 procedures were identified. Utilization was stable before Q2 2020, when a significant decline occurred following the onset of COVID-19. Rates recovered through 2021. After Q1 2022, a modest immediate increase was observed, followed by a sustained downward trend through 2024. Sleeve gastrectomy accounted for approximately two-thirds of procedures throughout the study period. Conclusions: Bariatric surgery utilization was markedly disrupted by COVID-19 and showed limited sustained growth after guideline expansion. These patterns might be a reflection of more general changes in the management of obesity, such as the growing accessibility of medication.<\/jats:p>","DOI":"10.3390\/jcm15124591","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T08:57:58Z","timestamp":1781513878000},"page":"4591","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Bariatric Surgery Utilization Trends in the United States Following COVID-19 and the 2022 ASMBS\/IFSO Guideline Expansion: An Interrupted Time Series Analysis"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4852-1166","authenticated-orcid":false,"given":"Abdulrahman A.","family":"Alsuhibani","sequence":"first","affiliation":[{"name":"Department of Pharmacy Practice, College of Pharmacy, Qassim University, Buraydah 51452, Qassim, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,13]]},"reference":[{"key":"ref_1","first-page":"1","article-title":"Prevalence of obesity and severe obesity among adults: United States, 2017\u20132018","volume":"360","author":"Hales","year":"2020","journal-title":"NCHS Data Brief."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2440","DOI":"10.1056\/NEJMsa1909301","article-title":"Projected US state-level prevalence of adult obesity and severe obesity","volume":"381","author":"Ward","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1002\/oby.22378","article-title":"Obesity as a disease: The Obesity Society 2018 position statement","volume":"27","author":"Jastreboff","year":"2019","journal-title":"Obesity"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"989","DOI":"10.1056\/NEJMoa2032183","article-title":"Once-weekly semaglutide in adults with overweight or obesity","volume":"384","author":"Wilding","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1143","DOI":"10.1056\/NEJMoa1700459","article-title":"Weight and metabolic outcomes 12 years after gastric bypass","volume":"377","author":"Adams","year":"2017","journal-title":"N. Engl. J. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"879","DOI":"10.1001\/jama.2020.12567","article-title":"Benefits and risks of bariatric surgery in adults: A review","volume":"324","author":"Arterburn","year":"2020","journal-title":"JAMA"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1134","DOI":"10.1016\/j.soard.2022.06.284","article-title":"American Society for Metabolic and Bariatric Surgery 2020 estimate of metabolic and bariatric procedures performed in the United States","volume":"18","author":"Clapp","year":"2022","journal-title":"Surg. Obes. Relat. Dis."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1345","DOI":"10.1016\/j.soard.2022.08.013","article-title":"American Society for Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO): Indications for metabolic and bariatric surgery","volume":"18","author":"Eisenberg","year":"2022","journal-title":"Surg. Obes. Relat. Dis."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1056\/NEJMoa2206038","article-title":"Tirzepatide once weekly for the treatment of obesity","volume":"387","author":"Jastreboff","year":"2022","journal-title":"N. Engl. J. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e2540890","DOI":"10.1001\/jamanetworkopen.2025.40890","article-title":"Prescribing Trends of Glucagon-Like Peptide 1 Receptor Agonists for Type 2 Diabetes or Obesity","volume":"8","author":"Li","year":"2025","journal-title":"JAMA Netw. Open."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"640","DOI":"10.1016\/S2213-8587(20)30157-1","article-title":"Bariatric and metabolic surgery during and after the COVID-19 pandemic: DSS recommendations","volume":"8","author":"Rubino","year":"2020","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1200\/CCI.17.00067","article-title":"Using a federated network of real-world data to optimize clinical trials operations","volume":"2","author":"Topaloglu","year":"2018","journal-title":"JCO Clin. Cancer Inform."},{"key":"ref_13","unstructured":"American Society for Metabolic and Bariatric Surgery (2022, October 20). CPT and ICD-9 Codes for Bariatric Surgery. Available online: https:\/\/asmbs.org\/resources\/cpt-and-icd-9-codes-for-bariatric-surgery."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"ooad035","DOI":"10.1093\/jamiaopen\/ooad035","article-title":"A global federated real-world data and analytics platform for research","volume":"6","author":"Palchuk","year":"2023","journal-title":"JAMIA Open"},{"key":"ref_15","unstructured":"(2025, March 24). TriNetX Real-World Data for the Life Sciences and Healthcare. Available online: https:\/\/trinetx.com\/."},{"key":"ref_16","unstructured":"Centers for Medicare, and Medicaid Services (2025, April 07). National Coverage Determination (NCD) for Bariatric Surgery for Treatment of Co-morbid Conditions Related to Morbid Obesity (100.1), Available online: https:\/\/www.cms.gov\/medicare-coverage-database\/view\/ncd.aspx?ncdid=57."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1016\/j.soard.2019.12.022","article-title":"American Society for Metabolic and Bariatric Surgery 2018 estimate of metabolic and bariatric procedures performed in the United States","volume":"16","author":"English","year":"2020","journal-title":"Surg. Obes. Relat. Dis."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1038\/nrgastro.2016.170","article-title":"Bariatric surgery for obesity and metabolic disorders: State of the art","volume":"14","author":"Nguyen","year":"2017","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1323","DOI":"10.1001\/jamasurg.2014.2440","article-title":"Long-term outcomes of bariatric surgery: A National Institutes of Health symposium","volume":"149","author":"Courcoulas","year":"2014","journal-title":"JAMA Surg."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/12\/4591\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T09:39:59Z","timestamp":1781516399000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/12\/4591"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,13]]},"references-count":19,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["jcm15124591"],"URL":"https:\/\/doi.org\/10.3390\/jcm15124591","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,13]]}}}