Predictors of surgical intervention for those seeking bariatric surgery

Abstract

Background: Bariatric surgery has been found to be effective in the treatment of severe obesity. Studies have shown that the majority of eligible patients do not undergo surgery.

Objectives: It is important to identify variables that may impact patient decision making and potentially lead to the disproportionate underutilization of bariatric surgery.

Setting: The study was conducted at one academic medical center in central Pennsylvania.

Methods: Bariatric patients who participated in a preoperative psychological assessment from 2017 to early 2020 completed comprehensive self-report questionnaires addressing sociodemographic variables, health history, psychopathology, and eating behaviors. Body mass index was calculated based on clinical measurements of each patient at the start of the preoperative program. Sociodemographic variables and self-report instrument scores were compared between those who completed surgery and those who did not.

Results: Of the 1234 participants, significant differences were found between the compared variables. All minority groups were less likely to undergo surgery than White patients. Participants reporting higher impairment were less likely to progress to surgery. Impairments across 3 behavioral eating assessments were associated with a lower likelihood of surgery.

Conclusion: There are multiple factors that contribute to patient progression to surgery, and ultimately whether the patient undergoes bariatric surgery. Results show a need for further investigation surrounding the sociodemographic and psychosocial variables that influence the patient's advancement to surgery. Both providers and patients could benefit from a deeper understanding of potential barriers to utilization of bariatric surgery.

Keywords: Bariatric surgery; Barriers to care; Binge eating; Food insecurity; Psychosocial health; Social determinants of health; Surgical weight loss.