You need to be motivated if you want weight loss surgery

Anna, a 30-year-old patient with obesity is determined to change her life. She has struggled all her life with obesity but despite her best efforts and motivation to lose weight, she has been unable to do so. So, she decides to discuss weight loss surgery with her doctor.  

What is weight loss surgery? 

Weight loss surgery is an operation that helps people with obesity lose weight by making several changes to their digestive system. For instance, by removing or rerouting the stomach. The benefits of weight loss surgery are many. For Anna the surgery would lead to weight loss, more energy, improved mobility, less joint pain, and healthy blood pressure, cholesterol levels and blood sugars. Anna would also have a lower risk of chronic disease, and better sleep. Anna may also be able to take part in activities that she was unable to do before, such as playing sports. And then, of course there are the benefits that are not physical, for instance improved self-esteem, mood, and confidence that come along with the weight loss.  

What determines referral for weight loss surgery 

In Anna’s world, healthcare professionals such as general practitioners, hold the key to this life-changing surgery that can help her overcome her struggles with obesity. Not everyone who is eligible for surgery will be referred for the procedure. So, we interviewed a couple of healthcare professionals to get their views on what factors determine referral behaviour. One important factor was whether patients met the criteria for bariatric surgery. Another important factor was patient’s motivation. However, different healthcare professionals had conflicting views on what constituted motivation.  

Proving your motivation to lose weight is difficult 

So now for Anna to get access to this life-changing procedure she is faced with the daunting task of proving her motivation to lose weight to the healthcare professionals. But how does one prove motivation to lose weight when healthcare professionals have conflicting views of what constitutes motivations. In our interviews, one healthcare professional believed that multiple attempts at weight loss demonstrates patient’s motivation, while another believed that simply expressing interest in surgery is enough.  

This leaves me wondering, why is the fate of a person living with obesity determined by something so subjective as motivation and what happens to those who are not considered ´motivated’ enough to receive this life-changing procedure? If motivation is indeed a factor that determines who gets access to weight loss surgery, healthcare professionals should come together to agree upon a more standardised way of determining patient motivation.  

Franshelis Garcia is lecturer and PhD researcher at Wageningen University & Research, chair group Health & Society. Her research focusses on the perceptions, experiences, and consequences of the stigma surrounding bariatric surgery from the perspective of people with obesity who are considering or awaiting surgery, post bariatric surgery patients, the general public and healthcare professional. Read more about Franshelis’ research project here: Stigma towards Bariatric Surgery: Prevalence and Impact.