Why Do Patients Drop Out of Bariatric Programs?
Bariatric Friday – January 16, 2026
Why Do Patients Drop Out of Bariatric Programs?
On this week’s episode of Bariatric Friday, Kemal Erkan and Dr. Isaias Irgau explore a critical and often misunderstood question: why do some patients disengage from bariatric programs before reaching surgery?
Many patients enter bariatric care with the assumption that the process will be quick or relatively straightforward. In reality, bariatric surgery is not a shortcut—it is a comprehensive, multi-step medical journey. When expectations are not properly set from the outset, frustration can follow. Clear communication, education, and transparency are essential to helping patients navigate this life-altering decision with confidence and clarity.
Dr. Irgau observes that bariatric surgery has, in many ways, become a victim of its own success. Advances in safety and outcomes have understandably increased public confidence, but they have also led to a dangerous misconception: that surgery requires minimal effort or commitment. What is often overlooked is the discipline, accountability, and permanent lifestyle transformation required for long-term success. Surgery is a powerful tool—but it is not passive.
Erkan emphasizes another critical dimension of the discussion: psychology. Obesity is rarely a simple matter of food intake alone. Emotional health, stress, trauma, and mental well-being play a central role in shaping a person’s relationship with food. Eating frequently serves as a coping mechanism—offering temporary relief from anxiety, depression, or life pressures. As Dr. Irgau underscores, psychological readiness is not a bureaucratic requirement; it is foundational. Some patients are not yet prepared to confront the emotional drivers behind their habits, and that realization can lead them to step away. Major life events—such as divorce, job loss, or the death of a loved one—can further intensify emotional eating behaviors. Identifying and addressing these underlying triggers is essential to achieving sustainable outcomes.
The complexity of the pre-operative process itself can also be overwhelming. Bariatric patients are often required to complete multiple medical clearances, including cardiology, psychology, nutrition, and laboratory evaluations. Without consistent guidance and strong institutional support, this can feel burdensome. Dr. Irgau stresses the importance of explaining the “why” behind each requirement. When patients understand that every step exists to protect their safety and maximize their success, the process becomes purposeful rather than punitive.
Erkan also highlights a practical but significant barrier: insurance authorization. Approval timelines can extend four to five weeks—or longer—and often require peer-to-peer reviews that delay care. One distinguishing factor of American Surgery Center is its streamlined communication model and cost-effective structure, which reduce friction for patients and improve efficiency across the process.
Finally, the discussion addresses a common emotional hurdle: pre-operative weight loss. Some patients become discouraged when they struggle to lose weight before surgery, questioning whether they will succeed afterward. Dr. Irgau points out the flaw in that reasoning. The very inability to achieve meaningful weight loss through traditional methods is often the strongest indication that surgical intervention is appropriate. Bariatric surgery is not a failure—it is a research-backed, evidence-based solution when other approaches have fallen short. Rather than a reason to withdraw, this realization should be seen as validation that a different, more effective tool is needed.
This episode serves as a reminder that bariatric care is not merely about surgery—it is about preparation, partnership, and long-term commitment. When patients are supported medically, psychologically, and logistically, their chances of success increase dramatically.