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. 2022 Jul;224(1 Pt B):429-436.
doi: 10.1016/j.amjsurg.2021.12.022. Epub 2021 Dec 23.

Individual-level barriers to bariatric surgery from patient and provider perspectives: A qualitative study

Jacqueline A Murtha  1 , Esra Alagoz  1 , Catherine R Breuer  1 , Alex Finn  1 , Susan D Raffa  2 , Corrine I Voils  3 , Luke M Funk  4
Affiliations

Individual-level barriers to bariatric surgery from patient and provider perspectives: A qualitative study

Jacqueline A Murtha et al. Am J Surg. 2022 Jul.

Abstract

Background: Less than 1% adults in the United States who meet body mass index criteria undergo bariatric surgery. Our objective was to identify patient and provider perceptions of individual-level barriers to undergoing bariatric surgery.

Methods: Adults with severe obesity and obesity care providers described their experiences with the bariatric surgery care process in semi-structured interviews. Using conventional content analysis, individual-level barriers were identified within Andersen's Behavioral Model of Health Services Use.

Results: Of the 73 individuals interviewed, 36 (49%) were female, and 15 (21%) were non-white. Six individual-level barriers were identified: fear of surgery, fear of lifestyle change, perception that weight had not reached its "tipping point," concerns about dietary changes, lack of social support, and patient characteristics influencing referral.

Conclusions: Patient and provider education should address patient fears of surgery and the belief that surgery is a "last resort." Bariatric surgery programs should strengthen social support networks for patients.

Keywords: Bariatric surgery; Individual-level barriers; Patient barriers; Patient perceptions; Provider perceptions.

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Figures

Figure 1:
Figure 1:. Flowchart detailing patient and provider recruitment
PCP: Primary care providers; HP: Health psychologist; BSP: Bariatric surgery provider; RD: Registered dietician
See this image and copyright information in PMC

References

    1. Campos GM, Khoraki J, Browning MG, Pessoa BM, Mazzini GS, Wolfe L. Changes in Utilization of Bariatric Surgery in the United States From 1993 to 2016. Ann Surg. 2020;271(2):201–209. 10.1097/sla.0000000000003554 - DOI - PubMed
    1. Chang S-H, Stoll CRT, Song J, Varela JE, Eagon CJ, Colditz GA. The Effectiveness and Risks of Bariatric Surgery. JAMA Surg. 2014;149(3):275. 10.1001/jamasurg.2013.3654 - DOI - PMC - PubMed
    1. Mingrone G, Panunzi S, De Gaetano A, et al. Bariatric-metabolic surgery versus conventional medical treatment in obese patients with type 2 diabetes: 5 year follow-up of an open-label, single-centre, randomised controlled trial. Lancet. 2015;386(9997):964–973. 10.1016/s0140-6736(15)00075-6 - DOI - PubMed
    1. Arterburn DE, Telem DA, Kushner RF, Courcoulas AP. Benefits and Risks of Bariatric Surgery in Adults. JAMA. 2020;324(9):879. 10.1001/jama.2020.12567 - DOI - PubMed
    1. Coleman KJ, Fischer H, Arterburn DE, et al. Effectiveness of Gastric Bypass Versus Gastric Sleeve for Cardiovascular Disease: Protocol and Baseline Results for a Comparative Effectiveness Study. JMIR Res Protoc. 2020;9(4):e14936. 10.2196/14936 - DOI - PMC - PubMed