Division of Upper GI and General Surgery, Department of Surgery, Keck School of Medicine of USC, Los Angeles, California.
Karsh Division of Gastroenterology and Hepatology, Cedars-Sinai Medical Center, Los Angeles, California.
J Surg Res. 2023 Mar;283:385-406. doi: 10.1016/j.jss.2022.10.061. Epub 2022 Nov 23.
Bariatric surgery is an effective therapeutic modality for obesity and related comorbidities, yet it remains significantly underutilized. Patient perceptions and expectations may influence the decisions of eligible patients in pursuing surgery.
PubMed, SCOPUS, and OVID databases were searched in July 2022 to identify published studies discussing patient and the public's perceptions of bariatric surgery.
The literature shows participants often reported bariatric surgery to be a life-changing intervention known to induce weight loss, improve obesity-related comorbidities, and improve quality of life. However, a significant proportion of survey respondents perceived bariatric surgery as unsafe or risky. Patients belonging to racial minority groups cited higher concern with mortality risk, lower weight loss expectations, and different motivations to pursue bariatric surgery. Female patients were significantly more likely to have more positive perceptions of, and higher expectations of weight loss from, bariatric surgery.
The literature highlighted discordance between patient perceptions and the demonstrated clinical safety and efficacy profile of bariatric surgery. Overestimations of the risks, unrealistic expectations, and unfamiliarity with bariatric surgery outcomes were common findings. These perceptions of bariatric surgery may contribute to its underutilization among eligible patients. Perceptions and motivations often varied by race, region, sex, and age, which demonstrates the necessity of patient-centered education in the prereferral stage. The literature also demonstrated misconceptions of bariatric surgery among the public. Further research should explore the impact of education on the perceptions of patients and the public.
减重手术是治疗肥胖症及相关合并症的有效治疗方法，但它的应用仍然明显不足。患者的看法和期望可能会影响有资格接受手术的患者的决策。
2022 年 7 月，我们在 PubMed、SCOPUS 和 OVID 数据库中进行了检索，以确定讨论患者和公众对减重手术看法的已发表研究。
文献表明，参与者通常报告减重手术是一种改变生活的干预措施，已知可诱导体重减轻、改善肥胖相关合并症并提高生活质量。然而，相当一部分调查受访者认为减重手术不安全或有风险。属于少数族裔的患者更担心死亡率风险、较低的减肥预期以及不同的减肥动机。女性患者对减重手术的看法明显更为积极，对减重手术的期望也更高。
文献强调了患者对减重手术的看法与临床安全性和疗效之间的不一致。对风险的高估、不切实际的期望以及对减重手术结果的不熟悉是常见的发现。这些对减重手术的看法可能导致其在有资格的患者中应用不足。看法和动机往往因种族、地区、性别和年龄而异，这表明在预转诊阶段需要以患者为中心的教育。文献还表明公众对减重手术存在误解。进一步的研究应该探索教育对患者和公众看法的影响。
