• Boris Zevin, Nardhana Sivapalan, Linda Chan, Nicholas Cofie, Nancy Dalgarno, and David Barber.
• Associate Professor in the Department of Surgery at Queen's University in Kingston, Ont. Boris.Zevin@kingstonhsc.ca.
• Can Fam Physician. 2022 Mar 1; 68 (3): e107e117e107-e117.

ObjectiveTo identify barriers to and facilitators of primary care provider (PCP) referral for bariatric surgery in patients with obesity.Data SourcesMEDLINE, EMBASE, and PsycINFO databases were searched and reference lists of included articles were screened to identify additional relevant articles. Two reviewers independently reviewed citations and full-text articles, and appraised the quality of the included articles using the Critical Appraisal Skills Programme Tool Qualitative Checklist and the Appraisal Tool for Cross-Sectional Studies. They extracted data on the study characteristics and the barriers to and facilitators of PCP referral for bariatric surgery. Appraisal discrepancies were resolved through consensus among authors.Study SelectionOverall, 882 citations were identified and 18 articles were then selected for this review.SynthesisBarriers included fear of surgery complications and side effects, cost, lack of availability, perception that surgery is a quick fix or a last resort, and prior negative experiences. Facilitators included direct requests from patients, patient motivation, previously failed weight-loss interventions, and obesity-related comorbidities. Those PCPs who were knowledgeable about the risks and benefits of bariatric surgery were more likely to refer their patients.ConclusionEducation and continuing professional development programs regarding bariatric surgery are needed to improve PCP knowledge and capacity to manage patients with obesity. Also, educating the general public on obesity, weight management, and available treatment options can empower patients and families to manage their weight and pursue evidence-informed treatments.Copyright© 2022 the College of Family Physicians of Canada.

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