Emre ERDOĞAN, Berk KONCALIOĞLU, Furkan TÜRKOĞLU, Elif Nur GENCER, Rabia KÜÇÜKARSLAN GÜLER, Soner SARI, Özgür DOĞAN
Journal of Health Sciences and Medicine - 2026;9(5):1509-1518
Aims: This study evaluated healthcare professionals' perceptions, clinical practices, and referral patterns regarding bariatric surgery in overweight or obese patients with musculoskeletal pain, and identified factors associated with referral decision-making. Methods: A cross-sectional survey was completed by 603 healthcare professionals from multiple specialties. The questionnaire assessed clinical exposure to obese patients with musculoskeletal pain, body-mass index (BMI) assessment practices, weight-loss recommendations, attitudes toward bariatric surgery, referral criteria, and factors influencing referral decisions and referral center selection. Results: Overall, 405 participants (67.2%) reported that at least one-quarter of their patients with musculoskeletal pain were overweight or obese. Although 422 (70.0%) consistently recommended weight loss and 463 (76.8%) considered weight reduction highly effective for symptom relief, only 68 (11.3%) routinely assessed BMI. Bariatric surgery was regarded as moderately or highly effective by 515 participants (85.4%), and 572 (94.9%) believed it could reduce the need for orthopaedic surgery. The most common indication for bariatric surgery referral was obesity refractory to conservative treatment (67.4%). Referral criteria differed significantly according to age (p=0.034), specialty (p<0.001), and institution (p<0.001). Referral center selection was primarily influenced by familiarity with and trust in a specific physician (70.8%) and varied by age, gender, specialty, and institution (all p<0.001). Conclusion: Despite recognizing the importance of weight reduction and the benefits of bariatric surgery, healthcare professionals infrequently assess BMI and inconsistently refer eligible patients. This awareness-referral gap highlights the need for clearer multidisciplinary referral pathways for obese patients with musculoskeletal pain.
