Highlights
- •We interviewed 45 patients and providers (surgeons, dietitians, health psychologists, PCPs).
- •SES barriers after bariatric surgery included employment, income, and transportation challenges.
- •Unsafe/inconvenient neighborhoods and limited health literacy were also barriers.
- •Interventions targeting these factors are needed to support bariatric surgery patients.
Abstract
Background
Disparities in socioeconomic status (SES) have been associated with less weight loss
after bariatric surgery. The objective of this study was to identify socioeconomic
barriers to weight loss after bariatric surgery.
Methods
We performed semi-structured interviews with bariatric surgery patients and providers
from April–November 2020. Participants were asked to describe their post-operative
experiences regarding dietary habits, physical activity, and follow-up care. Interview
data were coded using Directed Content Analysis based on domains in Andersen's Behavioral
Model of Health Services Use and Torain's Surgical Disparities Model.
Results
24 patients (median of 4.1 years post-operatively; mean age 50.6 ± 10.7 years; 12
bypass and 12 sleeve; 83% female) and 21 providers (6 bariatric surgeons, 5 registered
dietitians, 4 health psychologists, and 6 primary care providers) were interviewed.
Barriers to weight loss included: 1) challenging employment situations; 2) limited
income; 3) unreliable transportation; 4) unsafe/inconvenient neighborhoods; and 5)
limited health literacy.
Conclusions
Interventions targeting socioeconomic barriers to weight loss are needed to support
patients, particularly those who are socioeconomically disadvantaged.
Keywords
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Article info
Publication history
Published online: September 26, 2022
Accepted:
September 22,
2022
Received in revised form:
September 1,
2022
Received:
June 13,
2022
Identification
Copyright
Published by Elsevier Inc.
