Bariatric Surgery Popularity Study: How Popular is Bariatric Surgery by State and City

Interest in bariatric surgery is rising in the United States. Each year, with the exception of 2020, more and different types of obesity reduction surgeries are being performed. Renew Bariatrics gathered together web search data, bariatric surgery center data, and obesity statistics to give a holistic picture of the contemporary landscape of metabolic and bariatric surgical science. Renew Bariatrics compiled this data to create an “Interest Score” that models the popularity of this procedure for US cities and states. 

Table of Contents:

1. State Findings
2. City Findings
3. Bariatric Surgery Types
4. Methodology

Bariatric Surgery Popularity by State

Unsurprisingly the larger, populous states such as Texas, Florida and New York lead the way in the total number of surgery providers. However, when state populations taken from the Census are included, North Dakota becomes by far the best state for the availability of bariatric surgery per capita. North Dakota with 21 providers comes in as the dark horse in surgical access. Other surprising states in the top five per capita include, Rhode Island, New Hampshire,  Louisiana, and Kansas.

Adding in state health monitoring data from the Centers for Disease Control (CDC) helps round out the geographic obesity treatment picture. As a part of the Behavioral Risk Factor Surveillance System (BRFSS) respondents self-report their height and weight. Calculating the Body Mass Index (BMI) from the responses leads to a measure of the percentage of the population that is considered obese. This mapped data shows that obesity risk is concentrated in the Southeast, Midwest and Appalachia.  Nearby states with plentiful surgery centers like Texas, Florida, or Illinois are likely to absorb some extra demand from these areas if the actual state’s per capita access score is low.  

Further, search keyword data shows the states with the most requested information about surgeons and procedures. Again, the big states like Texas and Florida show their numerical strength. But other states with fewer providers but significant demand drive traffic, such as Arkansas, Mississippi and Delaware. Our Interest Score results capture this nuance of both availability and demand for procedures across disparate states.

Finally, Renew Bariatrics used the providers per state along with the data from the The American Society of Metabolic and Bariatric Surgery to estimate the number of surgeries performed in each state and city.  Review the full table below to see how your state stacks up for bariatric medical access. 

State	Surgeons	Estimated Surgeries	Surgeons per 100k	Obesity Rate	Interest Score
Texas	301	30,377	38	36%	62.1
Florida	157	15,844	27	32%	52.2
North Dakota	21	2,119	100	35%	48.7
Louisiana	54	5,450	43	40%	46.3
New Jersey	96	9,688	38	29%	45.8
New York	228	23,009	42	30%	43.2
Delaware	10	1,009	37	38%	42.3
Rhode Island	16	1,615	54	31%	41.2
Arkansas	16	1,615	20	37%	40.4
Mississippi	19	1,917	24	40%	39.1
Missouri	43	4,340	26	36%	38.5
Georgia	63	6,358	22	37%	37.8
Alabama	33	3,330	24	38%	37.5
Kentucky	24	2,422	20	38%	37.0
New Hampshire	20	2,018	54	30%	37.0
West Virginia	11	1,110	23	41%	36.9
Connecticut	39	3,936	40	31%	36.6
Kansas	34	3,431	43	36%	36.0
Tennessee	50	5,046	27	39%	35.9
Iowa	29	2,927	34	37%	35.9
Oklahoma	27	2,725	25	40%	34.8
Maryland	44	4,440	26	33%	34.6
Arizona	31	3,128	16	33%	34.4
South Dakota	10	1,009	42	37%	34.3
California	231	23,312	22	28%	33.7
Indiana	54	5,450	29	38%	33.6
Pennsylvania	116	11,707	33	33%	33.6
Ohio	75	7,569	24	38%	33.5
Nevada	20	2,018	24	34%	33.5
Wyoming	4	404	26	34%	33.5
South Carolina	41	4,138	29	35%	33.4
Idaho	9	908	18	33%	33.3
Maine	14	1,413	38	33%	33.2
Michigan	61	6,156	22	35%	32.9
North Carolina	91	9,184	32	34%	32.3
Virginia	69	6,963	30	35%	32.2
Minnesota	53	5,349	34	34%	32.1
Illinois	105	10,596	30	33%	31.8
Nebraska	15	1,514	28	35%	31.6
Washington	65	6,560	31	32%	30.9
Massachusetts	67	6,762	35	27%	30.6
Utah	16	1,615	18	31%	30.4
New Mexico	3	303	5	32%	30.3
Oregon	31	3,128	27	31%	30.2
Colorado	30	3,028	19	25%	27.7
Wisconsin	35	3,532	22	38%	27.4
Alaska	2	202	10	32%	26.8
Montana	5	505	17	31%	26.7
Hawaii	4	404	10	26%	17.9
Vermont	1	101	6	27%	16.9

Bariatric Surgery Popularity by City

Drilling down into our city findings shows that Houston, Texas comes out on top of our Interest Score rankings with over 50 surgeons, high obesity risk and significant search popularity. When factoring in the populations of these bustling cities, different centers of bariatric practice emerge. Atlanta and Tampa have significantly higher rates of surgeons per capita, with percentages approximately 193% and 190% above average for urban metros. The average for US cities is 1.97 surgeons per 100,000 people. They are followed by Miami and Dallas. The relative strength of the Southeast should be unsurprising given the prevalence of obesity risk in this area as identified by the CDC. 

Miami, in fact, was also highly sought after in the search data with the third highest search volume. Miami shows a significantly higher interest in bariatric surgery, with a search volume 305% above the average. Other metro areas do not have listed bariatric practices but do have substantial potential patient interest indicated in the search volume. Among those, Orlando comes in the highest followed by Birmingham,  St. Louis and New Orleans, all with high marks. This again shows the strength of demand for surgical obesity treatment in the Southeast and Midwest. 

Look for your city’s information below. 

City	State	Estimated Surgeries	Surgeons	Surgeons per 100k	Obesity Risk	Interest Score
Houston	Texas	5,551	55	63	36%	61.9
Atlanta	Georgia	1,917	19	100	37%	52.7
Tampa	Florida	1,514	15	99	32%	52.6
Miami	Florida	1,211	12	70	32%	50.9
Dallas	Texas	2,523	25	51	36%	44.1
San Antonio	Texas	1,817	18	32	36%	43.2
Raleigh	North Carolina	1,514	15	83	34%	40.7
Jacksonville	Florida	1,514	15	41	32%	39.5
Las Vegas	Nevada	1,211	12	48	34%	39.4
Nashville	Tennessee	1,615	16	61	39%	37.9
Tulsa	Oklahoma	908	9	57	40%	37.7
Minneapolis	Minnesota	1,110	11	68	34%	37.7
Louisville	Kentucky	1,009	10	42	38%	37.5
Orlando	Florida	0	0	0	32%	37.1
Omaha	Nebraska	1,211	12	65	35%	36.9
Baltimore	Maryland	1,312	13	60	33%	36.8
Phoenix	Arizona	505	5	8	33%	35.3
Fresno	California	706	7	34	28%	33.7
Memphis	Tennessee	505	5	21	39%	33.0
Portland	Oregon	1,413	14	58	31%	32.7
Boston	Massachusetts	1,312	13	52	27%	31.7
Chicago	Illinois	2,422	24	24	33%	31.3
Austin	Texas	908	9	24	36%	31.2
Little Rock	Arkansas	0	0	0	37%	31.0
Bakersfield	California	404	4	26	28%	31.0
Los Angeles	California	2,523	25	17	28%	30.6
Lexington	Kentucky	0	0	0	38%	30.5
Birmingham	Alabama	0	0	0	38%	30.5
Odessa	Texas	0	0	0	36%	30.1
New Orleans	Louisiana	0	0	0	40%	30.1
Kansas City	Missouri	101	1	5	36%	30.0
Albany	Georgia	0	0	0	37%	29.9
Laredo	Texas	0	0	0	36%	29.5
Abilene	Texas	0	0	0	36%	29.5
Oklahoma City	Oklahoma	606	6	23	40%	29.2
Indianapolis	Indiana	807	8	24	38%	28.8
Beaumont	Texas	0	0	0	36%	28.5
San Angelo	Texas	0	0	0	36%	28.4
Colorado Springs	Colorado	505	5	27	25%	28.3
El Paso	Texas	404	4	16	36%	28.1
Bluefield	West Virginia	0	0	0	41%	27.9
Joplin	Missouri	0	0	0	36%	27.9
Detroit	Michigan	505	5	21	35%	27.8
Columbus	Mississippi	0	0	0	40%	27.8
St. Louis	Missouri	0	0	0	36%	27.7
Tucson	Arizona	202	2	10	33%	27.7
Philadelphia	Pennsylvania	1,211	12	20	33%	27.7
Charleston	West Virginia	0	0	0	41%	27.6
Columbus	Ohio	807	8	23	38%	27.4
Wheeling	West Virginia	0	0	0	41%	27.4

 Bariatric Surgery Types Performed

The American Society of Metabolic and Bariatric Surgery (ASMBS) keeps estimates of the types of surgeries performed each year. A review of trends in this data reveals which surgical methods are becoming more popular with clinicians and patients over time. The dataset tracks five kinds of surgeries: Gastric Sleeve, RYGB (Roux-en-Y Gastric Bypass), Band, BPD-DS (Biliopancreatic Diversion with Duodenal Switch), and Revision surgeries. The most recent data from ASMBS covers the decade between 2011 and 2021.

Overall, the number of procedures is growing in popularity year over year. The effects of the COVID lockdown in 2020 are also clearly visible, as is the swift rebound in procedures to pre-COVID levels in 2021.

The most striking individual trend has been the notable increase in the number of Gastric Sleeve surgeries performed. The number quintupled to over 150,000 in 2021. As a percentage of total procedures Sleeve surgeries started with only 8.9% of the total and rose to a whopping 29.07% in 2021! Gastric sleeve surgeries are the most performed type of bariatric surgery today.  

Conversely,  Gastric Band surgeries have significantly decreased over the years. From a high of 55,932 in 2011, they dropped to just 1,121 in 2021. There’s a clear downward trend in Band surgeries, decreasing from 17.7% to just 0.21%. This sharp decline indicates a significant shift away from surgeons suggesting this type of surgery.

Methodology:

Renew Bariatrics created rankings of the 50 states  and top 50 metro areas by combining provider per capita, search popularity, and obesity risk. Search volume was calculated using one month of 2023 search traffic volume for “Bariatric Surgery in”, “Bariatric Surgeon in” and “Gastric Sleeve” and collated by state or city geography. Search popularity used Google Trends data for “Bariatric Surgery in” and “Sleeve Gastrectomy” for one year, also collated by state or city geography.  Interest scores were the normalized average of the surgeons per capita, obesity risk, search volume, and search popularity. Each metric contributed a maximum of 25 points. Estimated surgery numbers assume an even distribution of events across known providers as a straight proportion as more detailed data on performed medical procedures is regulated by federal law. 

Sources:

• Data used to create this ranking include propriety surgery center and search data.
• CDC: Behavioral Risk Factor Surveillance System (BRFSS)
• ASMBS:  Estimate of Bariatric Surgery Numbers, 2011-2021
• Google: https://trends.google.com/trends/