Evidence map›Paper›PMID 42414772›Full record

ArticleSurgical endoscopy2026

Exploring barriers to care and patient perspectives in metabolic and bariatric surgery.

Justine O Chinn, Mark Shacker, Kayla Kulhanek, Jason Shen, Brian Ruhle, Yulia Zak, Dan E Azagury, Micaela M Esquivel

Abstract read
PubMed Publisher
In one paragraph

Article in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Justine O ChinnSchool of Medicine, Stanford University, Stanford, CA, USA. Jchinn1@stanford.edu.ORCID http://orcid.org/0000-0002-6447-872X
Mark ShackerSchool of Medicine, Stanford University, Stanford, CA, USA.
Kayla KulhanekSchool of Medicine, Stanford University, Stanford, CA, USA.
Jason ShenSchool of Medicine, Stanford University, Stanford, CA, USA.
Brian RuhleSchool of Medicine, Stanford University, Stanford, CA, USA.
Yulia ZakSchool of Medicine, Stanford University, Stanford, CA, USA.
Dan E AzagurySchool of Medicine, Stanford University, Stanford, CA, USA.
Micaela M EsquivelSchool of Medicine, Stanford University, Stanford, CA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionMetabolic and bariatric surgery (MBS) is the most effective treatment for severe obesity but requires extensive patient education and lifelong engagement. Although many patients achieve durable weight loss, some experience weight recurrence or adverse effects. This retrospective cohort study aimed to evaluate how patient experience and social determinants influence MBS outcomes.

methodsAfter institutional review board approval, an electronic survey was distributed to patients who underwent sleeve gastrectomy or Roux-en-Y gastric bypass at a single academic institution between 2018 and 2024. Survey domains included preoperative access to care, inpatient experience, and postoperative recovery. Survey responses were linked to patient demographics, comorbidities, procedure type, percent total body weight loss (%TBWL), and 30-day complications. Spanish-language surveys and telephone completion options were available. Responses were kept private from patients' care team.

resultsA total of 246 responses were analyzed. Respondents were predominantly women (84.1%), English-speaking (94.7%), White (40.7%), non-Hispanic or Latino (52.4%), and low-income for the region (58.8%). Common barriers included access to healthy food (23.1%), multivitamins (24.8%), protein shakes (21.5%), and gym or exercise equipment (22.6%). Patients with low-income were more likely to feel unprepared for discharge (26.1% vs 6.5%, p = 0.001), report greater-than-expected post-operative pain (30% vs 15%, p = 0.016), have less support after discharge (74% vs 87%, p = 0.017), and experience readmission (4.6% vs 0%, p = 0.043). Overall, 89% of patients would recommend surgery to their loved ones, 4% were neutral, and 6% would not recommend. Patients who would recommend surgery had higher %TBWL (22.5% vs 16.6%, p = 0.014). Barriers to affording protein shakes or multivitamins were associated with lower 12-month %TBWL (17.3% vs 23.5%, p = 0.001 and 18.4% vs 22.6%, p = 0.007), while limited access to exercise equipment was associated with longer length of stay (1.9 vs 1.5 days, p = 0.009).

conclusionThis study demonstrates that social determinants of health significantly influence patient experience and postoperative outcomes after MBS, underscoring the importance of identifying and addressing these barriers to improve recovery and weight loss outcomes.

Indexed as

Bariatric SurgeryHealth Services AccessibilityObesity, MorbidAdultFemaleGastric BypassHumansMaleMiddle AgedPatient SatisfactionRetrospective StudiesSocial Determinants of HealthWeight LossEquityMetabolic and bariatric surgeryPatient experienceSocial determinants of healthSurgical access

Identifiers

PMID42414772

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.