Understanding Preferences of Patients with Obesity for Metabolic Bariatric Surgery: A Comprehensive Adaptive Choice-Based Conjoint Analysis

ObjectiveThis study aims to identify and analyze the key factors influencing the decision-making process of patients considering metabolic bariatric surgery (MBS).SettingThe research was conducted at the metabolic bariatric surgery clinic of the Medical Research Institute Hospital, Alexandria University, Egypt.MethodPatient with obesity were recruited at the clinic before MBS. The surgical profiles were characterized by attributes including treatment method, recovery and reversibility, treatment tenure, expected weight loss, impact on associated medical problems, risk of complication, side effects, dietary changes, and out-of-pocket costs. Patients engaged in an online survey comprising sociodemographic data, Build Your Own (BYO) section, screening section, and choice tournament section. Adaptive choice-based conjoint analysis was employed to discern the preferences.ResultsOf the 299 respondents, the surgical profiles with the highest preference involved a loss of 80% of excess weight without any recurrence (14.67 [95%CI, 14.10 to 15.23]), 0% risk of complication (13.74 [95%CI, 13.03 to 14.45]), and absence of adverse effects (11.32 [95%CI, 10.73 to 11.91]). K-mean cluster analysis identified two distinct groups: ‘patients prioritize weight loss' group prioritized excess weight loss, surgery availability, and diet change, whereas 'patients prioritize avoidance of complications' group focused on the risk of complication, adverse effects, and the surgery mechanism.ConclusionsMBS candidates predominantly value weight loss without recurrence, followed by minimization of complication risks and adverse effects, within three years post-surgery. Conversely, initial out-of-pocket costs and resolution of medical conditions were deemed the least influential attributes.