Public Still Suspicious of Metabolic Surgery

Much of the public holds negative perceptions of metabolic surgery, a recent survey indicated.

About half of U.S. adults responding to a telephone survey said they believed weight loss surgery was mainly for cosmetic — rather than health-related — reasons, Heather Yeo, MD, MHS, of New York–Presbyterian and Weill Cornell Medicine in New York City, and colleagues reported in JAMA Surgery.

On top of that, nearly 40% of individuals felt that people who opted for weight loss surgery were choosing the “easy way out.”

Around 8% of respondents also thought that insurance should not cover medical procedures to help people lose weight under any circumstances. On the other hand, about one-fifth of respondents said these types of procedures should always be covered, while the majority felt that procedures should be covered by insurance but solely for the health benefits.

“[M]any patients who are eligible for weight loss surgery are either not being offered it or not seeking it, with highly prevalent negative attitudes toward weight loss surgery being a potential reason,” Yeo and co-authors wrote, adding that the “high prevalence of these attitudes potentially creates a difficult social environment for patients who opt for weight loss surgery.”

The analysis included responses from 948 adults — the majority of whom were non-Hispanic white individuals — who responded to the Cornell National Social Survey via telephone.

Male versus female participants tended to hold very different attitudes toward metabolic surgery, with women generally more favorable. Specifically, women were more likely to say weight loss surgery is mostly for health reasons compared with responses from men (OR 1.34, 95% CI 1.02-1.75).

Women were also about half as likely as men to feel as though surgery was the “easy was out” (OR 0.54, 95% CI 0.40-0.71) and that it should not be covered by health insurance (OR 0.48, 95% CI 0.29-0.81).

Perceptions of weight loss surgery also varied across difference races and ethnicities. For example, non-Hispanic black individuals were the most likely to feel that surgery is the easy way out compared with other races.

Those older than age 62 were more likely to hold negative perceptions of surgery, more often reporting that they think surgery is an easy way out and that it should not be covered by insurance, compared with younger participants. However, the older group were also the most likely to believe surgery is mostly for health reasons.

Politics also mattered, with those endorsing conservative views more likely to hold negative attitudes toward surgery versus those who said they had moderate or liberal political views. In particular, conservatives were less likely to think surgery is mostly for health reasons and more likely to think surgery is an easy way out and that insurance shouldn’t cover it.

The researchers said that based upon these findings, “the association between higher prevalence of negative attitudes and demographic groups not opting for weight loss surgery supports the hypothesis that these attitudes may be at least partly responsible for such low utilization of weight loss surgical procedures.”

As for tackling the public misperceptions regarding metabolic surgery, Yeo and co-authors said it will take both time and education. “There is no simple way to fix this problem,” they wrote. “It may take years of public and physician education regarding the health benefits of weight loss surgery to improve its perception and increase its utilization.”