Exploring the landscape of bariatric surgery in Africa: current provisions, challenges, and future prospects

Awareness of Metabolic Bariatric Surgery Among Medical Students and House Officers in Lagos, Nigeria: A Cross-Sectional Online Survey

Background Obesity poses a significant public health challenge globally as it is a risk factor for many non-communicable diseases (NCDs). Metabolic bariatric surgery (MBS) has proven to be a reliable method for ensuring sustained weight loss and sometimes resolution of obesity-related diseases. However, its uptake and utilization in Nigeria are low due to a variety of reasons, one of which may be insufficient knowledge and exposure to surgical methods of weight loss in medical school curricula. This study evaluated knowledge and attitudes regarding MBS among final-year medical students and house officers (HOs) in Lagos, Nigeria, who represent primary sources of health information for patients. Methods A cross-sectional study was conducted using a 19-point structured online questionnaire, which was divided into the following sections: demographics, knowledge assessment, and attitude measurement. This was distributed electronically using a convenience sampling technique to final-year medical students and HOs across Lagos teaching hospitals (April-July 2024). Ethical approval was not required for this study. Data analysis was performed using SPSS v27.0.1 (IBM Corp., Armonk, NY). Results A total of 203 responses were received. Of these, 117 respondents were female (57.6%), and 86 were male (42.4%). Final-year medical students accounted for 130 (64%), while HOs made up the remaining 73 (36%). Only eight respondents (3.9%) correctly identified all three primary indications for MBS. The failure of conservative methods of weight loss was the most correctly identified indication for MBS, selected by 66% of participants (n=134). Recognition of gastric bypass and sleeve gastrectomy was moderate, with 66.5% (n=135) and 63.5% (n=129) of respondents aware of these methods, respectively. However, only 29.6% (n=60) of respondents were aware of endoscopic balloon insertion. Notably, 94.6% (n=192) were unaware of bariatric services at their institutions, and 41.9% (n=85) reported no exposure to bariatric surgery in their medical school curriculum. There was significant uncertainty regarding surgical risk, with 47.3% (n=96) unable to compare MBS risks to common abdominal procedures. Additionally, 47.3% (96) anticipated social stigma associated with surgical weight loss interventions. Conclusion Nigeria is confronting a growing obesity epidemic that underscores the urgent need for a comprehensive national strategy. Central to this approach is the enhancement of medical education on obesity and MBS through targeted curriculum updates, ongoing professional development programs, and specialized training workshops. Such measures are essential to improving patient care and addressing the escalating burden of obesity in Nigeria.