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 Nearly half of randomly-chosen survey participants said they believe
the procedure is usually done for cosmetic rather than health
reasons, and about 40 percent thought people who choose the surgery
have taken "the easy way out," researchers report in JAMA Surgery.
"Across the United States, there are adults who have obesity, and
the health problems that come with obesity, who are not getting or
even seeking the care they need because of the social stigma with
being obese and having obesity surgery," said senior author Dr.
Heather Yeo of NewYork-Presbyterian/Weill Cornell Medicine in New
York City. "This is actually a problem with physicians, too. Often
they give patients advice to lose weight, but they don't refer the
patient to a weight loss specialist."
Weight loss surgery involves one of several techniques for making
the stomach smaller, to accommodate less food and curb appetite,
sometimes also rerouting part of the digestive tract to bypass part
of the intestines. Patients with a body mass index (BMI) in the
obese and severely obese ranges are considered good candidates for
the procedure.
These procedures, called bariatric surgery, can improve a host of
conditions, including diabetes, hypertension and joint pain, Yeo
said.
To assess how the public views bariatric surgery, Yeo and colleagues
got three questions added to The Cornell National Social Survey, an
annual survey that uses random-digit dial telephone sampling of
English-speaking U.S. adults.
The questions were: Do you think people mostly have weight loss
surgery for cosmetic or for health reasons?; Do you think weight
loss surgery is usually an "easy way out?"; and Should health
insurance cover medical procedures to help people lose weight?
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Of the 948 people who answered these questions, 49.4 percent thought
people had weight loss surgery for cosmetic reasons, 39.1 percent
said people usually chose surgery as "the easy way out" and just
19.2 percent thought insurance should always pay for it.
Women were 34 percent more likely than men to say the surgery was
for health reasons, 54 percent less likely to say it's "the easy way
out," and 48 percent less likely to say insurance shouldn't cover
it. Non-Hispanic blacks were 61 percent more likely than others to
call surgery "the easy way out."
The findings align with other researchers' findings, Yeo said.
"There have been smaller studies looking at who gets the surgery,"
she explained. "And the results parallel what we saw about social
stigma. The majority of people who get weight loss surgery are
Caucasian, more educated and more likely to have higher household
incomes."
"This just confirmed what a lot of people in this field know," said
Dr. Yijun Chen of the University of California, Los Angeles, who
wasn't involved in the study. "It's a big problem. And it continues
even as more and more data accumulates supporting surgery in the
treatment of patients with obesity."
Chen said he hears consistent responses from patients who've had
bariatric surgery: "About 90 percent felt it was one of the best
decisions they'd made in their lives. About 60 to 70 percent said
they had one regret: they didn't do it sooner. And the reason why
was stigma. The biggest issue in the field right now is, how do you
change that bias."
SOURCE: https://bit.ly/2zYq0Vd JAMA Surgery, online December 12,
2018.
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