Physicians’ perceptions and referral patterns regarding bariatric surgery in overweight and obese patients with musculoskeletal pain: a multidisciplinary cross-sectional survey

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Abstract
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
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