Unveiling societal biases: Exploring factors behind discrimination against bariatric surgery patients in The Netherlands, France, and the United Kingdom

Introduction: In the present study, we explored various reasons for the discrimination against individuals with obesity undergoing bariatric surgery among the public in the Netherlands, France, and the United Kingdom Methods: As part of a survey study, we asked respondents whether they believed individuals with obesity who had bariatric surgery were discriminated against. Subsequently, we asked respondents why theybelieved individuals who had surgery might face discrimination. A total of 1807 respondents participated in the survey, representing 600 from the Netherlands, 603 from France, and 604 from the United Kingdom. The data analysis involved identifying and examining prevalent themes. Results: Our findings show that individuals with obesity undergoing bariatric surgery encounter discrimination for various reasons. The general perception among the public is that discrimination against those who have undergone surgery is rooted in a combination of societal, cultural, and psychological factors. Specifically, negative societal stereotypes surrounding obesity, such as the perceptions of laziness, lack of self-discipline, and willpower, were identified as significant reasons for the discrimination faced by those who undergo surgery across the three countries. In France, cultural attitudes related to beauty standards and norms of bodily aesthetics were considered by a substantial part of the public as important reasons for discrimination. Notably in the Netherlands, there was a prevailing belief that individuals undergoing surgery for obesity face discrimination due to health misconceptions and misunderstandings about obesity. In their rationale, they highlight that individuals who discriminate lack understanding regarding the complexity that is obesity, fail to acknowledge obesity as a chronic condition and fail to understand the effort and perseverance it requires of patients ‘post-surgery to lose and maintain weight loss. Conclusion: This study represents a first step in documenting the reasons why individuals with obesity who undergo surgery are discriminated against. Additionally, our findings provide supporting evidence that the rationale and motivating factors behind the discrimination faced by individuals who undergo surgery may vary across countries. Recognizing the diverse societal attitudes and cultural perceptions highlighted in our study emphasizes the importance of tailored initiatives in education and advocacy. These efforts are essential to challenge negative stereotypes, address misconceptions, and promote understanding. By doing so, we can actively combat discrimination against those who seek or have undergone bariatric surgery.