Original articlePerceived barriers to bariatric surgery among morbidly obese patients
Section snippets
Methods
This was a prospectively designed study. The survey was performed at the Cleveland Clinic Florida by the Bariatric and Metabolic Institute in conjunction with the Department of Internal Medicine. We developed a 2-page standard questionnaire that was offered to morbidly obese patients in our institution (Appendix). These patients were seen by internal medical residents for other medical problems that were not surgically related at the outpatient clinic or during a hospitalization. The study was
Results
A total of 77 patients (41 women and 36 men) were enrolled in the present study (Table 1). Their median age was 51 years. Of the 77 patients, 9% were supermorbidly obese (BMI >50 kg/m2). Also, 26% were single, 56% were married, and 18% were widowed or divorced; 49% were white, 23% were Hispanics, 16% were African American, 5% were Native American, and 7% were another ethnicity. Only 5% of the patients were unemployed at the time of the survey. Only 40% of the 77 patients were physically active.
Discussion
Obesity has been listed as a disease condition for the past 3 decades [13], [14], [15]. The overall mortality rate has been .1–1.0% [4]. The specific contraindications to bariatric surgery are few and include mental or cognitive impairment and very severe co-existing medical conditions [16], [17], [18], [19], [20].
Bariatric surgery is well known to be associated with the improvement or resolution of medical conditions such as diabetes [21], hypertension, dyslipidemia, and sleep apnea [22], [23]
Conclusion
The barriers to bariatric surgery are likely multifactorial, involving patient and physician factors, health system factors, and socioeconomic factors. Although one might have the impression that a lack of health insurance was not the main reason for patients to not consider bariatric surgery, the present series was too small and the questionnaire was not validated for such a conclusion to be drawn. However, a lack of health insurance was not the main reason for patients to not consider
Disclosures
Dr. Rosenthal is a consultant to and speaker for, and has received an honorarium/educational grant from Covidien, Ethicon Endosurgery, and Synovis. All other authors claim no commercial associations that might be a conflict of interest in relation to this article.
Acknowledgments
We would like to thank Noam Rosenthal for suggesting the idea for the present study and Terence O'Keeffe for helping with the data analysis and manuscript revisions.
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