gastric bypass operations reported. The medically more significant effects include a dramatic reduction in comorbid conditions: Hyperlipidemia is corrected in over 70% of patients. Essential hypertension is relieved in over 70% of patients, and medication requirements are usually reduced in the remainder. Obstructive sleep apnea improves markedly with weight loss and bariatric surgery may be curative for sleep apnea. Snoring also reduces in most patients. Type 2 diabetes is reversed in up to 90% of patients usually leading to a normal blood-sugar level without medication, sometimes within days of surgery. Furthermore, Type 2 diabetes is prevented by more than 30-fold in patients with pre-diabetes. All these findings were first reported by Walter Pories and Jose F. Caro. Gastroesophageal reflux disease is relieved in almost all patients. Venous thromboembolic disease signs such as leg swelling are typically alleviated. Lower-back pain and joint pain are typically relieved or improved in nearly all patients. A study in a large prospective study of 2010 obese patients showed a 29% reduction in mortality up to 15 years following surgery (hazard ratio 0.71 when adjusted for sex, age, and risk factors), compared to a non-surgically treated group of 2037 patients. A meta-analysis of 174772 participants published in The Lancet in 2021 found that bariatric surgery was associated with 59% and 30% reduction in all-cause mortality among obese adults with or without type 2 diabetes respectively. This meta-analysis also found that median life-expectancy was 9.3 years longer for obese adults with diabetes who received bariatric surgery as compared to routine (non-surgical) care, whereas the life expectancy gain was 5.1 years longer for obese adults without diabetes. Concurrently, most patients are able to enjoy greater participation in family and social activities. Cost of gastric bypass The patient's out-of-pocket cost for Roux-en-Y gastric bypass surgery varies widely depending on method of payment, region, surgical practice and hospital in which the procedure is performed. Methods of payment in the United States include private insurance, such as Individual & Family coverage, Small Group coverage through an employer (Under 50 full-time employees) and Large Group coverage through an employer (50 or more full-time employees), public insurance (Medicare and Medicaid) and self-pay. Out of pocket costs for a patient with private or public insurance that specifically list bariatric surgery as a covered benefit include several insurance-policy-specific parameters such as deductible levels, coinsurance percentages, copay amounts and out of pocket limits. Patients without insurance