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Of these patients, those without continuous health insurance enrollment (n=188, having prevalent (pre-surgery) NDs (n=461), and missing baseline BMI (n=41) were excluded. Of patients analyzed (n=1153), about 30% had incident NDs, with a mean (SD) age and BMI at surgery of 46 (12) years and 48 (9.2) kg/m , respectively. Patients with one incident ND had higher total health care spending (coefficient=$41118, p-value0.01) and ED visits (IRR=1.86, p-value0.01). Those without pre-operative NDs may have a higher chance of having ND