Perceived Barriers in the Decision for Bariatric and Metabolic Surgery: Results from a Representative Study in Germany

  • C. Luck-SikorskiEmail author
  • F. Jung
  • A. Dietrich
  • C. Stroh
  • S. G. Riedel-Heller
Original Contributions



Attitudes of the general public may be an influencing factor for low surgery rates: When skepticism is high, support for individuals wanting or needing to undergo surgery may diminish. This study assesses the relevance of barriers to metabolic surgery.


The study was conducted using a representative sample of the German population (n = 1007). Participants were asked to imagine that they would have to decide for or against metabolic surgery and rate how this decision would be influenced by a number of reasons given to them (Likert scale). Results are presented by weight status.


The barrier found most irrelevant is that surgery could be considered cheating across all weight groups. About a fourth of the sample state that not knowing enough about surgery (28.5%), being afraid of surgery (28.3%), and potential negative consequences after surgery (24.5%) are reasons against metabolic surgery that were rated extremely relevant. Having obesity was a significant predictor of endorsement in two variables: feeling like cheating (lower probability for relevance, OR = 0.58, p = 0.025) and a lack of knowledge (lower probability for relevance, OR = 0.59, p = 0.031).


In summary, the public’s view of weight loss surgery lacks information about post-surgical consequences. It is important to address these points in the public and in social networks of patients as they may be pre- or antecedent of surgery stigma.


Metabolic surgery Bariatric surgery Attitudes Barriers General public 



This work was supported by the Federal Ministry of Education and Research (BMBF), Germany, FKZ, 01EO1501.

Compliance with Ethical Standards

The study was approved by the Ethics Committee of the University of Leipzig (approval number 267-15-24082015).

Conflict of Interest

CLS has received honoraria from Ethicon (Johnson & Johnson) for talks and consultation. All other authors declare that they have no conflict of interest.


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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Integrated Research and Treatment Center AdiposityDiseases (IFB)University of LeipzigLeipzigGermany
  2. 2.SRH University of Applied Health SciencesGeraGermany
  3. 3.Department of General, Abdominal and Pediatric SurgerySRH Municipal Hospital GeraGeraGermany
  4. 4.Institute of Social Medicine, Occupational Health and Public Health (ISAP)University of LeipzigLeipzigGermany
  5. 5.Integrated Research and Treatment Center AdiposityDiseases (IFB), Department of SurgeryUniversity of LeipzigLeipzigGermany

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