A substantial body of evidence, including randomized clinical trials, shows that bariatric/metabolic surgery is reasonably safe and also more effective than diet, exercise, and pharmacological therapies in patients with obesity and type 2 diabetes (T2D). On the basis of such evidence, in 2015 global clinical guidelines from the 2nd Diabetes Surgery Summit (DSS-2) – now formally endorsed by more than 55 major medical and surgical organizations from around the world – recommended surgery as a standard-of-care treatment for patients with obesity and T2D. However, the utilization of metabolic surgery remains low and funding for it is severely limited. The present research investigated public awareness of the efficacy of surgery and other available treatments for obesity and T2D.


In February 2019, we surveyed a total of 4,016 U.S. and U.K. adults. Google Consumer Surveys collected representative online samples in these two countries. Each respondent completed only one of two survey questions asking which treatment for obesity or for obesity and T2D they believed to be the most effective. Respondents could choose between self-directed diet and exercise, intensive lifestyle programs, obesity medications, and bariatric surgery. Diabetes medications were also an option for respondents to the question about T2D and obesity.


For either obesity or the combination of obesity and T2D, the largest number of respondents believed that self-directed diet and exercise is the most effective treatment. Between 39% and 59% of respondents gave this answer. This response was more common for U.K. than U.S. respondents. Relatively few respondents (9-16%) believed that bariatric surgery is the most effective treatment.


Contrary to clinical evidence, the largest number of adults in the U.S. and U.K. believe that self-directed diet and exercise is more effective than surgery for treating obesity or for obesity and T2D.