Patient Preferences for Bariatric Surgery: Findings from a Survey Using Discrete Choice Experiment Methodology

Abstract

Importance: Surgical options for weight loss vary considerably in risks and benefits, but the relative importance of procedure-associated characteristics in patient decision making is largely unknown. Objective: To identify patient preferences for risks, benefits, and other attributes of treatment options available to individuals who are candidates for bariatric surgery. Design, Setting, and Participants: This discrete choice experiment of weight loss procedures was performed as an internet-based survey administered to patients recruited from bariatric surgery information sessions in the State of Michigan. Each procedure was described by the following set of attributes: (1) treatment method, (2) recovery and reversibility, (3) time that treatment has been available, (4) expected weight loss, (5) effect on other medical conditions, (6) risk of complication, (7) adverse effects, (8) changes to diet, and (9) out-of-pocket costs. Participants chose between surgical profiles by comparing attributes. Survey data were collected from May 1, 2015, through January 30, 2016, and analyzed from February 1 to June 30, 2016. Main Outcomes and Measures: Estimated relative value of risks and benefits for leading weight-loss surgical options and marginal willingness to pay for procedure attributes. A latent class analysis identified respondent subgroups. Results: Among the 815 respondents (79.9% women; mean [SD] age, 44.5 [12.0] years), profiles of hypothetical procedures that included resolution of medical conditions (coefficient for full resolution, 0.229 [95% CI, 0.177 to 0.280; P