Time, money, and weight loss: a qualitative study exploring patients’ perspectives on randomization for bariatric surgery vs. an intensive non-surgical weight loss program
Open accessAbstract
BACKGROUND: Randomized controlled trials (RCTs) are foundational in advancing medical knowledge and patient care, offering high-quality evidence on the comparative effectiveness of healthcare interventions. However, a common challenge for RCTs is the recruitment of trial participants. To understand and overcome potential obstacles in recruitment for a clinical trial (the LightBAR trial, NCT06309238) comparing the effectiveness of bariatric surgery versus an intensive weight loss program, a qualitative study was conducted. METHODS: Nine patients from the public bariatric surgery waiting list participated in focus groups at a hospital in the Capital Region of Denmark. Vignette scenarios were utilized to prompt participants to reflect on barriers and facilitators for participation. Three patients participated in a follow-up interview. Data was analyzed using thematic analysis. RESULTS: Analysis revealed four main themes: (1) having waited long for surgery reduced participants' willingness to be randomized; (2) the cost of weight loss medication was a major concern for participants; (3) participants were concerned about the extra work involved in program participation; and (4) participants weighed the efficacy and potential negative side effects of surgery against those of an intensive weight loss program based on personal beliefs and experiences. CONCLUSIONS: Tailoring the recruitment strategy to patients' circumstances and concerns, and providing clear, patient-centered communication about the nature and potential implications of participating in the trial may improve recruitment success. TRIAL REGISTRATION: The LightBAR trial (NCT06309238). Registered on ClinicalTrials.gov on May 2, 2024.
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Cost has consistently been cited as one of the most common barriers toward initiating and continuing GLP1-RA treatment.
“Cost has consistently been cited as one of the most common barriers toward initiating and continuing GLP1-RA treatment, though there are still limited data on GLP1-RAs used solely for weight management.75,97,106”
From The societal implications of using glucagon-like peptide-1 receptor agonists for the treatment of obesity (2025) · cites this paper as [97]
In Results (“The cost of weight loss medication was a major concern for participants”; page not provided), participants describe cost as a financial burden, including one who stopped semaglutide because she could no longer afford it. The Discussion also calls medication cost a serious concern. This qualitative study supports cost as a barrier for its participants, but does not establish that it has consistently been one of the most common barriers to initiating and continuing GLP1-RA treatment generally. (LLM, conf=0.87)
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Scragg, J., Koutoukidis, D. A., Dirksen, C., Heitmann, B. L., & Jebb, S. A. (2025) · Med · doi:10.1016/j.medj.2025.100805 · Cited by 16 · see citing works
Self-citation
- Authors
- Tomova-Olsen, S. A., Kousgaard, M. B., Jensen, K. T., Reventlow, S., Christiansen, A.-K. L., Bojsen-Møller, K. N., Dirksen, C., & Overbeck, G.
- Affiliations
- University of Copenhagen (DK)
- Corresponding author
- Tomova-Olsen, Sofie Amalie
- ORCID
- Venue
- Trials
- Published
- 2025-04-04
- Volume
- 26
- Issue
- 1
- Pages
- 121-121
- ISSN
- 1745-6215 (ISSN-L)
- PMC
- PMC11971855
- OpenAlex
- W4409174938
- Cited by
- 1
- References
- 2
- Citations by year
- 2025: 1
- FWCI
- 0.91
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Trials (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (publishedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Copenhagen University
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics in Clinical Research
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Health Professions › Pharmacy › Obesity and Health Practices
- Keywords
- trial recruitment, randomized controlled trials, bariatric surgery, obesity, patient perspectives, waiting lists, barriers and facilitators, patient-centered communication
- MeSH terms
- Adult, Denmark, Female, Humans, Health Knowledge, Attitudes, Practice, Male, Middle Aged, Time Factors, Multicenter Studies as Topic, Weight Loss, Randomized Controlled Trials as Topic, Treatment Outcome, Focus Groups, Patient Selection, Qualitative Research, Bariatric Surgery, Weight Reduction Programs
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