Administrative barriers, not insurance coverage, pose the biggest obstacle to bariatric surgery access in the U.S., according to a study published Aug. 29, 2026, in the journal Obesity Surgery.
Researchers at the Medical University of South Carolina ran a secret shopper study, using trained callers who posed as prospective patients with Medicaid or private insurance. The callers contacted 35 metabolic and bariatric surgery centers — 18 in North Carolina and 17 in South Carolina — between June and August 2025.
Callers reached only 24 of the 35 centers, or 68.6%. Nine centers had incorrect contact information, and two offered only online intake forms with no phone option. Reaching a scheduler took an average of 1.7 calls per center.
Insurance type made little difference in access. All 24 centers that were reached accepted private insurance, and 94.3% accepted Medicaid. The median wait for an initial consultation was 20 days, ranging from three to 62 days, regardless of insurance type.
Most centers, 77.1%, required steps before scheduling an appointment, including online applications (45.8%), seminar attendance (29.2%), primary care physician referrals (25%) and screening questionnaires (20.8%). Nearly 23% of centers required two or more of these steps.
“Rather than insurance-related disparities, we found that administrative barriers such as repeated call attempts, inaccurate contact information, and variable prerequisites were the main obstacles,” the study’s authors said.
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