Expected Weight Loss, Cost Factor Heavily in Patients’ Decision about Bariatric Surgery

A new study, authored by Saint Louis University's Michael Rozier, S.J., Ph.D., while he studied health care policy at the University of Michigan, found that cost and how much weight one can lose matter more to patients considering weight-loss surgery than recovery time or the risk of complications.

The study was published in the journal JAMA Surgery.

Rozier, an assistant professor of health management and policy in SLU's College for Public Health and Social Justice, returned to Saint Louis University in August after four years at the University of Michigan and stint at Boston College.

Rozier got his undergraduate degree in chemistry at SLU. 

The survey of potential bariatric surgery patients found that the cost of the surgery ranks at the top of patients’ minds as they process all the factors which go into choosing a bariatric surgery procedure, Rozier said.

“What emerged from our study is that cost is a major factor, and it is one that isn’t discussed,” Rozier said. “We often discourage providers from discussing costs when making a medical decision because we don’t want it to interfere with that patient/provider relationship and yet it is critically important to patients.”

Rozier partnered on the study with senior author Lisa Prosser, Ph.D., a professor of pediatrics at the University of Michigan Medical School and member of the university’s Institute for Healthcare Policy and Innovation. He had adapted a research method initially used in marketing and a member of his dissertation committee suggested looking at bariatric surgery.

A bariatric surgical procedure causes weight loss by restricting the amount of food the stomach can hold. A gastric bypass creates a new smaller stomach pouch by dividing the top of the stomach and rerouting to bypass part of the small intestine, while a sleeve gastrectomy removes approximately 50 percent of the stomach.

The survey of 800 adults in Michigan considering surgery for weight loss also found that the most commonly performed operation, sleeve gastrectomy, doesn't meet patients' highest priorities. Patients who have sleeve gastrectomy lose less weight the first year, on average, than patients who have gastric bypass surgery.

Read more on the study from the University of Michigan

Rozier and the team from University of Michigan will have a companion study coming in the spring which looks at surgeons’ responses to the same survey.

“This will hopefully provide us a road map on the disconnects between patient and physician when discussing what factors into deciding which procedure is best,” Rozier said. 

College for Public Health and Social Justice

The Saint Louis University College for Public Health and Social Justice is the only academic unit of its kind, studying social, environmental and physical influences that together determine the health and well-being of people and communities. It also is the only accredited school or college of public health among nearly 250 Catholic institutions of higher education in the United States. 

Guided by a mission of social justice and focus on finding innovative and collaborative solutions for complex health problems, the College offers nationally recognized programs in public health, social work, health administration, applied behavior analysis, and criminology and criminal justice.