Qualitative study of 14 adult patients with prior or current GLP-1 receptor agonist use who chose to proceed with primary metabolic and bariatric surgery (MBS), using semi-structured interviews to identify motivations for transitioning to surgery.
Six themes drove patients toward MBS despite GLP-1 RA use: (1) preference for long-term, durable treatment; (2) desire to reduce comorbidities and health risks; (3) adverse aspects of prior treatments (e.g., GLP-1 side effects); (4) barriers to treatment access (including insurance); (5) social influences; and (6) differences in health care support systems.
Very small sample (n=14) from a single institution limits generalizability. Qualitative design captures themes but not prevalence or effect sizes. Selection bias is likely, as participants had already decided on surgery.
When managing patients on GLP-1 receptor agonists, clinicians should proactively discuss MBS as a complementary or alternative option — durability, side effect burden, and access barriers are key drivers of patient preference for surgery. Shared decision-making conversations should address all modalities.
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