Bariatric procedures all work the same way: They reduce your appetite and your body's ability to digest the food it consumes by changing the shape or size of your stomach to limit the amount of food you can eat at one time.

Two of the most popular types of bariatric surgery are Roux-en-Y gastric bypass and sleeve gastrectomy. These surgeries not only help people live healthier and more active lives, they also can significantly reduce patients' health care bills, according to a study by researchers at Duke University School of Medicine and Kaiser Permanente. It found that bariatric surgery significantly lowered health care costs, especially for adults dealing with type 2 diabetes and obesity.

Spending on medication by both groups dropped by more than half after bariatric surgery, from around $2,300 per six-month period during the two to three years prior to surgery to approximately $1,000 per six months after surgery.

The research was designed as a retrospective cohort study — in which the medical records of groups of individuals who are alike in many ways, but differ by a certain characteristic, are compared for a particular outcome.

In this instance, researchers compared health care costs of over 3,100 adults who underwent gastric bypass and 3,500 adults who had a sleeve gastrectomy between 2012 through 2019.

The looked at the health care costs of adults in the Kaiser Permanente Southern California and Kaiser Permanente Washington health systems with type 2 diabetes and a BMI (Body Mass Index) of 35 kg/m2 or higher three years before they had bariatric surgery and then five and a half years after surgery.

Health care expenses decreased dramatically in both groups.

People who had had a gastric bypass spent $4,039 per 6-month period before surgery but only $2,440 after surgery. The total expenses of the sleeve gastrectomy group dropped from about $3,900 per 6-month period before surgery to approximately $2,650 after surgery.

The only difference in cost noted was in the first 6 months after surgery when adults who underwent Roux-en-Y gastric bypass had higher health care spending than those who had sleeve gastrectomy.

The results show that bariatric procedures achieve belt tightening in two ways: physically and financially. “These findings support the use of bariatric surgery as an effective weight-loss intervention for adults with diabetes and severe obesity and highlights the economic benefits of bariatric surgery in managing diabetes and reducing long-term health care costs,” lead author of the study, Matthew Maciejewski, a professor in the department of population health sciences at Duke University and senior research career scientist at the Durham VA Medical Center, said in a press release.

The decline in total health care expenses was largely due to a drop in medication costs, Maciejewski noted. Medication spending for patients who had bariatric surgery dropped by more than half — from almost $2,300 per six-month period prior to surgery to approximately $1,000 per six months after surgery.

Approximately 93 million American adults are considered obese.

People who had a bariatric procedure achieved belt tightening in two ways: physically and financially.

There are other ways to work on losing weight in addition to bariatric surgery. The Centers for Disease Control recommends you start by paying attention to where you are. This method helps to identify how you want to improve your health. The CDC suggests tracking your:

  • Nutrition: Write down everything you consume for a few days in a food and beverage diary. This will help you see what you eat and drink and consider how to make small changes.
  • Physical activity: Include time of day, what activity you did, and duration in a physical activity diary.
  • Sleep: Include the hours of sleep you get. The amount you need changes as you age.
  • Stress: Include healthy ways you are reducing your stress.
  • Track other wellness factors — such as how you are feeling when you eat and drink and are active, and lifestyle challenges like smoking and drinking alcohol — too.

Surgery may sound like a scary option at first, but the benefits for your health and bank account could be substantial. Ask your doctor. Find out what he or she recommends. Seek out people who have already had weight-loss surgery and find out what they experienced.

The study is published in Annals of Internal Medicine.