Perceptions and Beliefs About Obesity and Bariatric and Metabolic Surgery Among Black and White Men

Although metabolic and bariatric surgery (MBS) is a safe and effective procedure to reduce severe obesity and is covered by most health insurance plans, utilization of MBS is significantly lower among men compared to women. This study identifies unique factors that explain men's attitude towards MBS.

The study survey (paper/online) included 129 Black and White men with severe obesity from metropolitan communities in Western New York. Bivariate and multivariate analyses were used to evaluate participants' personal and community factors influencing their consideration of MBS.

Men willing to undergo MBS had lower education (38% vs. 21% ≤ high school, p < 0.05), were less likely to be satisfied with their body weight (27% vs. 48%, p < 0.05), more likely to have a physician supporting their weight loss efforts (55% vs. 32%, p = 0.03) and discussing MBS treatment (39% vs. 19%, p = 0.02), believed that community role models who underwent MBS "lost weight and looked great" (66% vs. 40%, p = 0.02) and that MBS was safe and effective (40% vs. 13%, p < 0.01), compared to men unwilling to undergo MBS. When adjusted for education level, dissatisfaction with body size (odds ratio, OR = 4.56, 95% confidence interval, CI: 1.16, 18.01) and physician support (OR = 3.71, 95% CI: 1.17, 11.78) remained significantly associated with men's willingness to undergo MBS. Race and BMI were not associated with willingness to undergo MBS.

Positive attitude toward MBS among men is influenced by self-perception of excess weight, strong physician support and community role models. Improving patient-provider communication about MBS and awareness from community role models may improve MBS utilization among men.