Beyond the Operating Room: Determinants of Burnout and Resilience among Metabolic Bariatric Surgeons Worldwide.

introductionBurnout has emerged as an increasingly prevalent risk to the health and performance of surgeons. Metabolic and bariatric surgery (MBS) is a high-stakes, highly technical specialty with complex patient care and extended work hours coupled with heavy procedural demands. The purpose of this study was to evaluate the prevalence and determinants of burnout and resilience among MBS surgeons worldwide and identify variables responsible for these outcomes.

methodsA cross-sectional online survey was conducted between January-March 2025 among 419 International Federation for the Surgery and Other Therapies of Obesity (IFSO) members. The Maslach Burnout Inventory (MBI), the 10-item Connor–Davidson Resilience Scale (CD-RISC), and demographic, lifestyle, and professional questions were administered. All scoring followed validated norm-based methods.

resultsThe mean total MBI scores were 15.55 ± 9.65 for burnout (section A), 9.83 ± 7.65 for depersonalization (section B), and 36.82 ± 8.89 for personal achievement (section C), showing a low to moderate general burnout level overall. High emotional exhaustion and depersonalization were seen among older surgeons, those with sleeping problem, low physical activity, and longer surgical shifts. The levels of resilience (CD-RISC-10 mean = 28.75 ± 6.13) were higher in surgeons with high quality sleeping, greater experience, and academic involvement, but lower in those who actively engaged in research. Despite high burnout indicators, most participants reported strong personal accomplishment and purpose in their work. While nearly 95% of surgeons reported frequently performing laparoscopic surgery, the study does not demonstrate a correlation between this surgical approach and musculoskeletal symptoms (52%). Over half reported that long-term follow-up and the dealing with patient expectations were challenging, and that 73% experienced financial insecurity.

conclusionAvoiding burnout is challenging for MBS surgeons as well, particularly among those who suffer from poor sleep, heavy workloads, and limited physical activity. Nevertheless, most MBS surgeons reported high job satisfaction, good resilience skills, and low to moderate levels of burnout. Age, workload, physical activity, sleep quality, and teaching experience were key determinants of burnout and resilience. Future studies are necessary to not only find further determinants of burnout, but also the most efficient adaptation of each determinant, and targeted interventions to maintain MBS surgeon well-being.