Assessment of Outcomes Following Bariatric Surgery for Mississippi State Employees

Objective: to assess the health and economic outcomes (weight lost, change in control of
chronic diseases such as diabetes, quality of life, work productivity, health care cost, etc)
associated with bariatric (weight-loss) surgery for 200 severely obese patients who undergo
bariatric surgery as part of the Mississippi State Employees' Life and Health Insurance
Plan's Obesity Treatment Program (OTP).

2. Patient Characteristics: Inclusion criteria: Eligible bariatric surgical candidates who
are enrolled in the OTP (100 patients per year for 2 years). The Plan's criteria includes,
but is not limited to 1) enrollment in the plan for at least 12 consecutive months prior to
September 1, 2009; 2) completion of the HealthQuotient health risk assessment through the
Plan's wellness and health promotion program; 3) a Body Mass Index (BMI) of >40 kg/m2, or a
BMI >35 kg/m2 with two or more co-morbidities such as diabetes, hypertension, sleep apnea or
asthma; 4) two or more physician-supervised weight loss attempts within the last 24 months;
5) age 18 years or older; and 6) consent to provide personal and medical information to the
Plan. Prior to surgery, each site administers a psychiatric evaluation to ensure the patient
is psychologically stable for surgery. Exclusion criteria: any patient who does not meet
criteria above or who declines to participate. Surgeries will take place only at Certified
Bariatric Surgery Centers of Excellence (COE), of which, there are currently 3 in the state.
The 3 COEs exist with 4 outpatient medical offices (1 COE is composed of 2 independent
surgeon practices) Patients will be recruited at each site once they are approved by the OTP.

3. Design: prospective, observational, multi-center, longitudinal study of outcomes and
resource utilization associated with OTP. Estimates of obesity and comorbidities' impact will
be obtained from the outpatient medical office for the COEs. Medical charts, databases and
medical/pharmacy claims will be the source of information. Surveys on quality of life,
productivity, and patient satisfaction will be administered directly to patients. Database
claim information will be obtained in future and is not a part of current IRB application.

4: Procedures: After obtaining informed consent, patients will be administered surveys at
baseline, as well as at follow-up visits. Additional data will be obtained via patient
charts, databases, and medical/pharmacy claims.