Abstract
Background
It is estimated that 4.5 million youth in the United States have severe obesity (SO).
Metabolic and bariatric surgery (MBS) is the most effective and longitudinally durable
treatment for adolescents with SO, but only an estimated 1600 adolescents undergo
the procedure annually.
Objective
To understand patients’ perceptions and experiences with the barriers to MBS as an
adolescent.
Setting
This research was conducted at Children’s Hospital Colorado, an urban academic medical
center, and the University of Colorado Anschutz School of Medicine and Sanford Research,
a rural medical center.
Methods
We conducted 14 qualitative interviews with individuals who received MBS between the
ages of 19 and 25 years in the last 5 years regarding the barriers to MBS they experienced
as an adolescent. A formal qualitative analysis was conducted using the constant comparative
techniques of grounded theory generally guided by Anderson’s behavioral model of health
service use.
Results
We identified 3 principal groups of barriers related to (1) a lack of information
that MBS was an option and the absence of discussions about MBS with medical providers
while an adolescent, (2) a lack of access to MBS primarily related to insurance coverage,
costs, and family-related issues, and (3) a general stigma around MBS as a treatment
for obesity.
Conclusion
This study suggests that the primary barriers to MBS for adolescents with SO are related
to a general lack of information about MBS, social stigma, and access issues related
to costs that decrease or limit access.
Key words
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Article info
Publication history
Published online: March 22, 2022
Accepted:
March 13,
2022
Received:
December 16,
2021
Identification
Copyright
© 2022 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
