Perceptions of obesity and cancer risk in female bariatric surgery candidates: Highlighting the need for physician action for unsuspectingly obese and high risk patients

•Despite a mean BMI of 48.7 kg/m2, 29% of women did not recognize their obesity.•Most women identified obesity as increasing uterine cancer but half still perceived it was not likely/possible to develop it.•Menstrual irregularities (along with subsequent intervention) were exceedingly common and 32% had prior hysterectomy.

ObjectivesTo determine: 1) whether obese women perceive themselves to be obese or at risk for malignancy, 2) perceived impact of obesity on cancer risks, 3) compliance with cancer screening, and 4) rates of menstrual dysfunction.MethodsSurveys were administered to female patients presenting for bariatric weight loss surgery. Demographics, gynecologic history, perception of cancer risk, and screening history were collected/analyzed. Women were categorized as obese (BMI: 30–39 kg/m2), morbidly obese (40–49 kg/m2), super obese (≥ 50 kg/m2) and compared.ResultsNinety-three women (mean age: 44.9 years, mean BMI: 48.7 kg/m2) participated and 45.7% felt they were in ‘good’, ‘very good’, or ‘excellent’ health despite frequent medical comorbidities. As BMI increased, women were more likely to correctly identify themselves as obese (23% of obese vs. 77% of morbidly obese vs. 85% of super obese; p < 0.001) but there were no significant differences in comorbidities. Two-thirds of women correctly identified obesity as a risk factor for uterine cancer, yet 48% of those retaining a uterus perceived that it was “not likely/not possible” to develop uterine cancer. Menstrual irregularities were common as was evaluation and interventions for the same; 32% had prior hysterectomy. Participation in cancer screening was robust.ConclusionsWomen presenting for bariatric surgery have high rates of menstrual dysfunction. While they perceive that obesity increases uterine cancer risk, they often do not perceive themselves to be at risk. This disconnect may stem from the fact that many failed to identify themselves as obese perhaps because overweight/obesity has become the norm in U.S. society.