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SAGES 2026 Annual Meeting Emerging Technology Session
March 25-28, 2026 | Tampa, FL, USA
P187
Weight Stigma, Trust, and Decisions for Surgery: Untangling Barriers to Bariatric Care
Poster Presenter
Authors
Rama O'Dwyer, Nori Pham, Salma Hassan, Paul Kolm, Kristen Miller, Ana Leon, Sameer Alrefai, Ivanesa Pardo, Yewande Alimi
Affiliations
Georgetown University School of Medicine, Medstar Health Georgetown University, Center for Biostatistics, Informatics and Data Science, National Center for Human Factors in Healthcare, MedStar St. Mary's Hospital, Medstar Washington Hospital Center,
Part of Topic
Bariatric
Weight Stigma, Trust, and Decisions for Surgery: Untangling Barriers to Bariatric Care.
Obesity affects over 40% of U.S. adults and remains a major driver of morbidity and healthcare utilization.
Weight stigma in healthcare is pervasive and has been associated with reduced trust, delayed care-seeking, and poorer clinical outcomes.
Although bariatric surgery is the most effective long-term treatment for severe obesity, the role of perceived weight bias in influencing surgical decision-making remains unclear.
We aim to examine the mechanisms by which perceived weight stigma influences bariatric treatment utilization and to inform strategies aimed at reducing bias, enhancing patient–provider communication, and advancing equity in obesity care.
methods -
Cross-sectional and retrospective study of adults with severe obesity evaluated in a bariatric surgery clinic between 2022 and 2024, reported in accordance with STROBE guidelines.
Eligible participants were adults aged 18–100 years with BMI ≥35 kg/m² with an obesity-related comorbidity or BMI ≥40 kg/m² undergoing consultation for bariatric surgery or medical weight management.
Patients with prior bariatric surgery or deemed not surgical candidates were excluded.
Surveys assessing perceived weight bias were administered in person, by telephone, or via secure REDCap to minimize access-related exclusion bias.
Primary outcome was comparison of weight bias measures between patients who underwent bariatric surgery and those who did not; secondary outcomes included associations with demographics and postoperative BMI change.
Conclusion
In this cohort of individuals with obesity, perceived weight bias, internalized stigma, anticipated discrimination, and trust in healthcare providers did not differ significantly between those who pursued bariatric surgery and those who did not
Although weight bias was commonly reported, it did not independently determine surgical decision-making, suggesting that stigma alone may not serve as a decisive barrier to bariatric care.