Weight Stigma and Orthopedic Surgeons' Treatment Preferences for Patients With Obesity Who Are Candidates for Elective Total Knee Arthroplasty.

OBJECTIVE

This study aimed to examine how anti-fat attitudes and attitudes toward obesity management influence orthopedic surgeons' treatment preferences for patients with obesity who are candidates for elective total knee arthroplasty (TKA).

METHODS

A cross-sectional survey was conducted among 150 orthopedic surgeons using a web-based questionnaire. The survey included four sections: socio-demographic data, the Antifat Attitudes Questionnaire (AFA) assessing biases related to obesity (dislike, fear of fatness, and beliefs about willpower), an adapted questionnaire on attitudes toward obesity management, and a custom section on treatment preferences.

RESULTS

The sample had a mean age of 43.4 years (SD = 9.7) and was predominantly male (70.7%). Participants exhibited moderate anti-fat attitudes alongside positive views on obesity management. Stronger anti-fat attitudes correlated with a preference for conservative treatments over surgery ( = 0.45 to  = 0.29,  < 0.001), whereas supportive attitudes toward obesity management were associated with less preference for conservative treatment ( = -0.53,  < 0.001). Male surgeons demonstrated higher anti-fat attitudes and a greater inclination for conservative treatment than female surgeons. Regression analysis identified attitudes toward obesity management as a significant predictor of treatment preferences ( = -0.54,  < 0.001).

CONCLUSION

Findings highlight the impact of weight stigma on clinical decision-making and emphasise the need for increased awareness and education to ensure equitable access to TKA for patients with obesity.