To explore information-seeking behaviours, influences, expectations, and healthcare professional and psychosocial support needs among individuals preparing for bariatric surgery in New South Wales (NSW), Australia, and to examine differences across public/private and metropolitan/regional healthcare settings.

Baseline data were collected from a longitudinal, prospective cohort study (HREC 2020/ETH02984) using a purpose-designed questionnaire, from April 2021-September 2024. Adults were recruited from four bariatric services (two public, two private) across metropolitan and regional NSW. Outcomes included self-reported demographics, information sources, beliefs, and support needs prior to surgery.

Participants (n = 238) were predominantly female (79.0 %), aged 43 ± 11.3 years, with a median BMI of 44.5 kg/m² (IQR 39.4–49.7). Of the cohort, 74.0 % attended private and 66.8 % metropolitan services. Public participants had significantly higher BMI than private (48.3 vs 42.2 kg/m², p < 0.05). Key barriers to weight loss included stress, illness, medications, and limited support, particularly in regional and public groups. Most accessed information from the internet (72.0 %) and GPs (67.0 %), with GP involvement higher in regional (81.7 %) and public (82.5 %) settings. Peer experiences strongly influenced decision-making. Participants expected 33–35 % total weight loss, above typical Australian outcomes (29.0 %), and were motivated by health (94.7 %), quality of life (90.0 %), and activity (81.4 %). Common concerns included weight regain (90.0 %), excess skin (89.0 %), and dietary restrictions (75.0 %). Most (71.8 %) anticipated support for 12 months or less or were unsure.

Individuals preparing for bariatric surgery reported high expectations and varied healthcare professional and psychosocial support needs. Differences across settings highlight inequities in access, supporting the need for tailored, multidisciplinary care and realistic goal-setting.