Trends in Metabolic and Bariatric Surgery Procedure Volume Recorded in MBSAQIP, 2015-2024

Metabolic and bariatric surgery (MBS) is the most effective treatment for severe obesity; however, national procedure volume is not well characterized. We examined trends in MBS utilization in the United States from 2015 to 2024 using the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP).

We conducted a repeated cross-sectional analysis of the 2015-2024 MBSAQIP Participant Use Data Files. Patients were classified as adolescents (10-18 years) or adults (≥ 19 years). Annual procedure volumes were analyzed separately by age group using segmented negative binomial regression with a prespecified change point at 2022 to estimate annual percentage changes during 2015-2022 and 2022-2024.

A total of 1,970,021 patients completed MBS, including 1,964,090 adults and 5,931 adolescents. Sleeve gastrectomy was the most common procedure (61.8%), followed by Roux-en-Y gastric bypass (27.7%). Adult MBS utilization increased from 167,430 procedures in 2015 to 229,826 in 2022 before declining to 216,968 in 2023 and 176,915 in 2024. Adolescent utilization increased from 259 procedures in 2016 to 936 in 2023 before declining to 820 in 2024. Annual utilization increased significantly from 2015 to 2020 among both adults (p < 0.0001) and adolescents (P = 0.021) but declined significantly from 2022 to 2024 among adults (p < 0.001) and not adolescents (p = 0.98).

Annual MBSAQIP procedure volume increased through 2022 among adults and adolescents but declined in 2023-2024 only among adults. This emerging pattern warrants continued surveillance to determine whether it persists and to understand its implications for surgical access, treatment selection, and the delivery of obesity care.