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Obesity Surgery

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01-12-2019 | Obesity | Original Contributions

Perceived Barriers in the Decision for Bariatric and Metabolic Surgery: Results from a Representative Study in Germany

Authors: C. Luck-Sikorski, F. Jung, A. Dietrich, C. Stroh, S. G. Riedel-Heller

Published in: Obesity Surgery | Issue 12/2019

Abstract

Background

Attitudes of the general public may be an influencing factor for low surgery rates: When skepticism is high, support for individuals wanting or needing to undergo surgery may diminish. This study assesses the relevance of barriers to metabolic surgery.

Methods

The study was conducted using a representative sample of the German population (n = 1007). Participants were asked to imagine that they would have to decide for or against metabolic surgery and rate how this decision would be influenced by a number of reasons given to them (Likert scale). Results are presented by weight status.

Results

The barrier found most irrelevant is that surgery could be considered cheating across all weight groups. About a fourth of the sample state that not knowing enough about surgery (28.5%), being afraid of surgery (28.3%), and potential negative consequences after surgery (24.5%) are reasons against metabolic surgery that were rated extremely relevant. Having obesity was a significant predictor of endorsement in two variables: feeling like cheating (lower probability for relevance, OR = 0.58, p = 0.025) and a lack of knowledge (lower probability for relevance, OR = 0.59, p = 0.031).

Conclusions

In summary, the public’s view of weight loss surgery lacks information about post-surgical consequences. It is important to address these points in the public and in social networks of patients as they may be pre- or antecedent of surgery stigma.

Mensink GBM, Schienkiewitz A, Scheidt-Nave C. Overweight and obesity in Germany. Results of the German health interview and examination survey for adults (DEGS1). Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz [Internet]. 2013;56:786–94.CrossRef

Deutsche Gesellschaft für Allgemein- und Viszeralchirurgie. 1 S3-Leitlinie: Chirurgie der Adipositas und metabolischer Erkrankungen [Internet]; 2018 [cited 2019 Feb 13]. Available from: https://www.awmf.org/uploads/tx_szleitlinien/088-001l_S3_Chirurgie-Adipositas-metabolische-Erkrankugen_2018-02.pdf. Accessed 19 Feb 2019.

Lee W-J, Almalki O. Recent advancements in bariatric/metabolic surgery. Ann Gastroenterol Surg. 2017;1(3):171–9. https://doi.org/10.1002/ags3.12030.CrossRefPubMedPubMedCentral

Lenzen-Schulte M. Therapie der Fettleibigkeit: Nur Hürden statt Hilfe für Adipöse; [Treatment for obesity: barriers instead of help]. Dtsch Arztebl Int. 2018;115(11):A–484.

Gasoyan H, Tajeu G, Halpern MT, et al. Reasons for underutilization of bariatric surgery: the role of insurance benefit design. Surg Obes Relat Dis. 2019;15(1):146–51. 0(0). https://doi.org/10.1016/j.soard.2018.10.005.CrossRefPubMed

Jung FU, Luck-Sikorski C, Konig H-H, et al. Stigma and knowledge as determinants of recommendation and referral behavior of general practitioners and internists. Obes Surg. 2016;26(10):2393–401. https://doi.org/10.1007/s11695-016-2104-5.CrossRefPubMed

Jung FU, Dietrich A, Stroh C, et al. Changes in attitudes towards bariatric surgery after 5 years in the German general public. Obes Surg. 2017;27(10):2754–8. https://doi.org/10.1007/s11695-017-2822-3.CrossRefPubMed

Imbus JR, Voils CI, Funk LM. Bariatric surgery barriers: a review using Andersen’s model of health services use. Surg Obes Relat Dis. 2018;14(3):404–12. https://doi.org/10.1016/j.soard.2017.11.012.CrossRefPubMed

Funk LM, Jolles S, Fischer LE, et al. Patient and referring practitioner characteristics associated with the likelihood of undergoing bariatric surgery: a systematic review. JAMA Surg. 2015;150(10):999–1005. https://doi.org/10.1001/jamasurg.2015.1250.CrossRefPubMedPubMedCentral

10.

Ju T, Rivas L, Arnott S, et al. Barriers to bariatric surgery: factors influencing progression to bariatric surgery in a U.S. metropolitan area. Surg Obes Relat Dis. 2019;15(2):261–8. 0(0). https://doi.org/10.1016/j.soard.2018.12.004.CrossRefPubMed

11.

Leroux JS, Moore S, Dube L. Beyond the “I” in the obesity epidemic: a review of social relational and network interventions on obesity. J.Obes. 2013;2013(2090–0708 (Linking)):348249. https://doi.org/10.1155/2013/348249.CrossRefPubMedPubMedCentral

12.

Livhits M, Mercado C, Yermilov I, Parikh JA, Dutson E, Mehran A, et al. Is social support associated with greater weight loss after bariatric surgery?: a systematic review. England; 2011.

13.

Dolan P, Afaneh C, Symer M, et al. Assessment of public attitudes toward weight loss surgery in the United States. JAMA Surg. 2019; https://doi.org/10.1001/jamasurg.2018.4650.CrossRef

14.

Hansen B, Dye MH. Damned if you do, damned if you don’t: the stigma of weight loss surgery. Deviant Behav. 2018;39(2):137–47. https://doi.org/10.1080/01639625.2016.1263081.CrossRef

15.

Behr D, Harkness JA, Fitzgerald R, et al. Round 4 ESS translation strategies and procedures. London: European Social Survey, Centre for Comparative Social Surveys, City University; 2008.

16.

StataCorp LP. Stata statistical software: release 14. College Station, TX: StataCorp; 2015.

17.

Puhl RM, Heuer CA. Obesity stigma: important considerations for public health. AmJPublic Health. 2010;100(6):1019–28. https://doi.org/10.2105/AJPH.2009.159491.CrossRef

18.

Mattingly BA, Stambush MA, Hill AE. Shedding the pounds but not the stigma: negative attributions as a function of a target’s method of weight loss. J Appl Biobehav Res. 2009;14(3):128–44. https://doi.org/10.1111/j.1751-9861.2009.00045.x.CrossRef

19.

Vartanian LR, Fardouly J. The stigma of obesity surgery: negative evaluations based on weight loss history. Obes Surg. 2013;23(10):1545–50. https://doi.org/10.1007/s11695-013-0918-y.CrossRefPubMed

20.

Raves DM, Brewis A, Trainer S, et al. Bariatric surgery patients’ perceptions of weight-related stigma in healthcare settings impair post-surgery dietary adherence. Front Psychol. 2016;7:1497. https://doi.org/10.3389/fpsyg.2016.01497.CrossRefPubMedPubMedCentral

21.

Han S, Agostini G, Brewis AA, et al. Avoiding exercise mediates the effects of internalized and experienced weight stigma on physical activity in the years following bariatric surgery. BMC Obes. 2018;5:18. https://doi.org/10.1186/s40608-018-0195-3.CrossRefPubMedPubMedCentral

22.

Coblijn UK, Lagarde SM, Raaff d, et al. Patients’ preferences for information in bariatric surgery. Surg Obes Relat Dis. 2018;14(5):665–73. https://doi.org/10.1016/j.soard.2018.01.029.CrossRefPubMed

23.

Cheng Y-L, Shu J-H, Hsu H-C, et al. High health literacy is associated with less obesity and lower Framingham risk score: sub-study of the VGH-HEALTHCARE trial. PLoS One. 2018;13(3):e0194813. https://doi.org/10.1371/journal.pone.0194813.CrossRefPubMedPubMedCentral

Title: Perceived Barriers in the Decision for Bariatric and Metabolic Surgery: Results from a Representative Study in Germany
Authors: C. Luck-Sikorski
F. Jung
A. Dietrich
C. Stroh
S. G. Riedel-Heller
Publication date: 01-12-2019
Publisher: Springer US
Keywords: Obesity
Obesity
Bariatric Surgery
Bariatric Surgery
Published in: Obesity Surgery / Issue 12/2019
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI: https://doi.org/10.1007/s11695-019-04082-1

At a glance: The STEP trials

Springer Medicine

Perceived Barriers in the Decision for Bariatric and Metabolic Surgery: Results from a Representative Study in Germany

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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