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Perceived barriers to bariatric surgery among morbidly obese patients
Bianca B Afonso1, Raul Rosenthal, Ka Ming Li
1Department of Bariatric Surgery, Cleveland Clinic Florida, Weston, Florida 33331, USA.
Background:
Obesity has become a worldwide problem. Surgery has been shown to be a safe and effective therapy. We sought to identify those factors that patients regard as barriers to undergoing a bariatric surgical procedure.
Methods:
Morbidly obese patients were asked to complete a 2-page questionnaire during routine outpatient appointments or hospitalization for other reasons. Patients were enrolled from February 2007 to April 2008. The differences between groups were assessed using univariate analysis.
Results:
A total of 77 patients (41 women and 36 men) were enrolled. Their median age was 51 years, and 49% of the patients were white, followed by Hispanic (23%), and other ethnicities. Of the 77 patients, 9% were supermorbidly obese (body mass index >50 kg/m(2)), and 62% reported having used dieting to lose weight, with greater reports among the women (P = .01). White patients and those >55 years old were more likely to be using some type of weight loss program. Only 40% were physically active. African Americans reported greater rates of regular exercise (P <.01). Of the 77 patients surveyed, 8% had never heard of bariatric surgery. Finally, only 30% of our patient population considered themselves to be morbidly obese.
Conclusion:
The results from the present survey have demonstrated that a lack of insurance coverage is not the main reason for patients not consulting a center to be evaluated for bariatric surgery. Perceived barriers and lack of knowledge exist in both the minds of the general public and physicians.
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Cultural barriers:
Differences in values, beliefs, religion, knowledge, and tradition can significantly impact communication. Awareness of nonverbal cues is critical, especially when conversing with a patient from a different culture. What appears appropriate in one culture may be inappropriate in another.
Semantic barriers:
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