The prevalence of class 3 obesity (body mass index ≥40 kg/m²) is 7.7% of the United States adult population; thus, more than 25 million people may be medically appropriate for consideration of bariatric surgery as therapy for severe obesity. Although bariatric surgery is the most effective therapy for patients with severe obesity, the surgery is performed in less than 1% of patients annually for whom it may be appropriate. Patients’ and medical professionals’ misperceptions about obesity and bariatric surgery create barriers to accessing bariatric surgery that are not given adequate attention and clinical consideration. Commonly cited patient barriers are lack of knowledge about the severity of obesity, the perception that obesity is a lifestyle problem rather than a chronic disease, and fear that bariatric surgery is dangerous. Medical professional barriers include failing to recognize causes of obesity and weight gain, providing recommendations that are inconsistent with current obesity treatment guidelines, and being uncomfortable counseling patients about treatment options for severe obesity. Previous research has revealed that medical professional counseling and accurate perception of the health risks associated with severe obesity are strong predictors of patients’ willingness to consider bariatric surgery. This article reviews patient and medical professional barriers to acceptance of bariatric surgery as a treatment of medical necessity and offers practical advice for medical professionals to rethink perspectives about bariatric surgery when it is medically and psychologically appropriate.

3级肥胖（体重指数≥40kg / m ^2）的患病率）是美国成人人口的7.7％；因此，有超过2500万人在医学上适合将减肥手术作为严重肥胖症的治疗方法。尽管减肥手术是重度肥胖患者最有效的治疗方法，但每年只有不到1％的患者适合进行减肥手术。患者和医务人员对肥胖症和减肥手术的误解造成了进入减肥手术的障碍，这些障碍没有得到足够的重视和临床考虑。人们普遍提到的患者障碍是：对肥胖的严重程度缺乏了解；对肥胖是一种生活方式问题而不是一种慢性疾病的认识；以及担心减肥手术是危险的。医疗专业人员的障碍包括无法识别肥胖和体重增加的原因，提供与当前肥胖治疗指南不一致的建议，以及不愿意为患者提供有关严重肥胖的治疗选择的咨询服务。先前的研究表明，医学专业咨询和对与严重肥胖相关的健康风险的准确认识是患者考虑进行减肥手术的强烈预兆。本文回顾了患者和医学专业人士接受减肥手术作为治疗医学必需品的障碍，并为医学专业人员在医学和心理上适当的情况下重新考虑减肥手术的观点提供了实用建议。提供与当前肥胖症治疗指南不一致的建议，并且不建议患者就严重肥胖症的治疗选择提供咨询。先前的研究表明，医学专业咨询和对与严重肥胖相关的健康风险的准确认识是患者考虑进行减肥手术的强烈预兆。本文回顾了患者和医学专业人士接受减肥手术作为治疗医学必需品的障碍，并为医学专业人员在医学和心理上适当的情况下重新考虑减肥手术的观点提供了实用建议。提供与当前肥胖症治疗指南不一致的建议，并且不建议患者就严重肥胖症的治疗选择提供咨询。先前的研究表明，医学专业咨询和对与严重肥胖相关的健康风险的准确认识是患者考虑进行减肥手术的强烈预兆。本文回顾了患者和医学专业人士接受减肥手术作为治疗医学必需品的障碍，并为医学专业人员在医学和心理上适当的情况下重新思考减肥手术的观点提供了实用建议。先前的研究表明，医学专业咨询和对与严重肥胖相关的健康风险的准确认识是患者考虑进行减肥手术的强烈预兆。本文回顾了患者和医学专业人士接受减肥手术作为治疗医学必需品的障碍，并为医学专业人员在医学和心理上适当的情况下重新考虑减肥手术的观点提供了实用建议。先前的研究表明，医学专业咨询和对与严重肥胖相关的健康风险的准确认识是患者考虑进行减肥手术的强烈预兆。本文回顾了患者和医学专业人士接受减肥手术作为治疗医学必需品的障碍，并为医学专业人员在医学和心理上适当的情况下重新考虑减肥手术的观点提供了实用建议。