Perspectives of Patients Seeking Bariatric Surgery: The Impact of Early Patient-Provider Communication on Bariatric Surgery Utilization.

Introduction: Bariatric surgery (BS) is an effective and durable long-term treatment for severe obesity, yet less than 1% of eligible patients undergo surgery. Thus, we explored the perceptions and experiences of patients with obesity seeking BS prior to obtaining a referral for surgery.

Methods: A survey was prospectively administered to patients who were referred to our institution from March 25, 2023, to May 28, 2024. Questions assessed patients' initial exposure to BS, perceptions of its safety and efficacy, who initiated referral discussions, and whether patients would have considered surgery earlier if prompted by their healthcare provider. Statistical analyses included Chi-square test. Qualitative analysis using thematic analysis was conducted for free-text responses.

Results: Out of 327 patients invited, 118 completed the survey (36.1%). The majority of participants (57.9%) initiated discussions about BS with their provider, and 79.7% would have considered BS sooner if approached earlier. Respondents had considered BS for 3.8 years on average (standard deviation = 5.3). The most important contributions of BS for patients were "improved health" (94.1%) and "improved appearance" (31.6%). The most commonly reported barriers to obtaining a referral included cost (55.1%), followed by safety (45.8%) and efficacy (33.1%) concerns.

Discussion: Our findings underscore the importance of proactive and early engagement between providers and patients regarding BS referrals. Addressing safety and efficacy concerns through comprehensive patient education by providers may improve BS referral rates by removing patients' perceived barriers to care. Financial concerns remain a significant barrier to BS utilization and should be further investigated and addressed.