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Patient and the Public's Perceptions of Bariatric Surgery: A Systematic Review

Published:November 23, 2022DOI:https://doi.org/10.1016/j.jss.2022.10.061

      Highlights

      • Perceptions of bariatric surgery (BS) play a role in willingness to pursue BS.
      • BS is perceived as a tool for weight loss, comorbidity resolution, and improving QOL.
      • Negative perceptions regarding the safety and efficacy of BS were prevalent.
      • There is notable demographic variation within the perceptions of BS.
      • Patient and public education may improve perceptions and utilization rates.

      Abstract

      Introduction

      Bariatric surgery is an effective therapeutic modality for obesity and related comorbidities, yet it remains significantly underutilized. Patient perceptions and expectations may influence the decisions of eligible patients in pursuing surgery.

      Methods

      PubMed, SCOPUS, and OVID databases were searched in July 2022 to identify published studies discussing patient and the public's perceptions of bariatric surgery.

      Results

      The literature shows participants often reported bariatric surgery to be a life-changing intervention known to induce weight loss, improve obesity-related comorbidities, and improve quality of life. However, a significant proportion of survey respondents perceived bariatric surgery as unsafe or risky. Patients belonging to racial minority groups cited higher concern with mortality risk, lower weight loss expectations, and different motivations to pursue bariatric surgery. Female patients were significantly more likely to have more positive perceptions of, and higher expectations of weight loss from, bariatric surgery.

      Conclusions

      The literature highlighted discordance between patient perceptions and the demonstrated clinical safety and efficacy profile of bariatric surgery. Overestimations of the risks, unrealistic expectations, and unfamiliarity with bariatric surgery outcomes were common findings. These perceptions of bariatric surgery may contribute to its underutilization among eligible patients. Perceptions and motivations often varied by race, region, sex, and age, which demonstrates the necessity of patient-centered education in the prereferral stage. The literature also demonstrated misconceptions of bariatric surgery among the public. Further research should explore the impact of education on the perceptions of patients and the public.

      Keywords

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