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Sonneville KR, Thurston IB, Gordon AR, Richmond TK, Weeks HM, Lipson SK. Weight Stigma Associated With Mental Health Concerns Among College Students. Am J Prev Med 2024; 66:260-268. [PMID: 37758003 DOI: 10.1016/j.amepre.2023.09.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 09/21/2023] [Accepted: 09/21/2023] [Indexed: 09/29/2023]
Abstract
INTRODUCTION Weight stigma is widespread and exists across numerous domains including health care, educational institutions, workplaces, mass media, and interpersonal relationships. Weight stigma experienced during the college years may be particularly consequential because the college years are a period of increased vulnerability for the development of mental health concerns. The purpose of the present study was to examine how experiences of weight stigma relate to mental health concerns, including symptoms of eating disorders, anxiety, and depression, among college students. METHODS Prevalence of interpersonal and anticipated weight stigma was examined among 2,707 students participating in the 2018-2019 and 2019-2020 Healthy Minds Study and tested for differences in prevalence across student characteristics. Logistic regression was used to explore relationships between measures of weight stigma and student mental health. Analyses were conducted in 2021-2023. RESULTS Interpersonal and anticipated weight stigma were reported by 12.3% and 15.3% of students, respectively. Experiences of interpersonal and anticipated weight stigma were generally lowest among cisgender male students, heterosexual students, those with the fewest financial concerns, and those who did not perceive themselves to be "overweight." Both interpersonal and anticipated weight stigma were associated with elevated odds of high weight concerns, past-month binge eating, past-month purging, high eating disorder risk, moderate/severe anxiety symptoms, and moderate/severe depressive symptoms. CONCLUSIONS Findings implicate interpersonal and anticipated weight stigma as potential risk factors for a range of mental health concerns. Weight stigma is an under-recognized and under-funded public health problem.
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Affiliation(s)
- Kendrin R Sonneville
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan.
| | - Idia B Thurston
- Departments of Health Sciences and Applied Psychology, Institute for Health Equity and Social Justice Research, Northeastern University, Boston, Massachusetts
| | - Allegra R Gordon
- Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts
| | - Tracy K Richmond
- Division of Adolescent/Young Adult Medicine, Department of Pediatrics, Harvard Medical School, Boston Children's Hospital, Boston, Massachusetts
| | - Heidi M Weeks
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Sarah K Lipson
- Department of Health Law Policy and Management, Boston University School of Public Health, Boston, Massachusetts
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2
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Graham CE, Frisco ML. The Mental "Weight" of Discrimination: The Relationship between Perceived Interpersonal Weight Discrimination and Suicidality in the United States. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2023; 64:610-625. [PMID: 37776190 PMCID: PMC10683344 DOI: 10.1177/00221465231200634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/02/2023]
Abstract
Extant research has investigated the relationship between body weight and suicidality because obesity is highly stigmatized, leading to social marginalization and discrimination, yet has produced mixed results. Scholars have speculated that factors associated with body weight, such as weight discrimination, may better predict suicidality than body weight itself. We consider this possibility among a sample of 12,057 adult participants ages 33 to 43 in Wave V of the National Longitudinal Study of Adolescent to Adult Health through investigation of the relationships between weight discrimination and two dimensions of suicidality-suicide ideation and attempts. We also examine gender as a moderator of these relationships. We find that weight discrimination is positively associated with both suicide ideation and attempts, and this relationship is similar among men and women. Our findings underscore the need to address issues of weight discrimination in our society to better promote mental well-being.
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Davidson JC, Kent BV, Cozier YC, Kanaya AM, Warner ET, Eliassen AH, Williams DR, Shields AE. "Does Religious Service Attendance Modify the Relationship between Everyday Discrimination and Risk of Obesity? Results from the Study on Stress, Spirituality and Health". J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01765-5. [PMID: 37921946 PMCID: PMC11065965 DOI: 10.1007/s40615-023-01765-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 07/18/2023] [Accepted: 08/15/2023] [Indexed: 11/05/2023]
Abstract
This study examined the association of everyday discrimination with risk of obesity and the potential modifying effect of religious service attendance. Participants included Black, South Asian, and white women in three cohort studies that belong to the Study on Stress, Spirituality and Health. Logistic regression models estimated odds of obesity classification (BMI ≥ 30) relative to experiences of everyday discrimination. In initial pooled analyses, high levels of discrimination were related to increased odds of obesity. Race-specific analyses revealed marginal associations for white and South Asian women. Among Black women, high levels of discrimination and religious service attendance were both associated with higher odds of obesity. However, among women who attended religious services frequently, higher levels of everyday discrimination were associated with slightly lower odds of obesity. These findings underline the complex association between obesity and religion/spirituality, suggesting that higher levels of discrimination may uniquely activate religious resources or coping strategies. Findings highlight the need for additional studies to examine the impact of everyday discrimination on risk of obesity across racial/ethnic communities and how religious practices or coping strategies might affect these dynamics.
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Affiliation(s)
- James Clark Davidson
- Massachussetts General Hospital, Boston, MA, USA.
- Harvard Medical School, Boston, MA, USA.
- Westmont College, Santa Barbara, CA, USA.
| | - Blake Victor Kent
- Massachussetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Westmont College, Santa Barbara, CA, USA
| | - Yvette C Cozier
- Slone Epidemiology Center at Boston University, Boston, MA, USA
- Boston University School of Public Health, Boston, MA, USA
| | - Alka M Kanaya
- University of California San Francisco, San Francisco, CA, USA
| | - Erica T Warner
- Massachussetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - A Heather Eliassen
- Harvard Medical School, Boston, MA, USA
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Brigham and Women's Hospital, Boston, MA, USA
| | | | - Alexandra E Shields
- Massachussetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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Kunin-Batson A, Carr C, Tate A, Trofholz A, Troy MF, Hardeman R, Berge JM. Interpersonal Discrimination, Neighborhood Inequities, and Children's Body Mass Index: A Descriptive, Cross-Sectional Analysis. FAMILY & COMMUNITY HEALTH 2023; 46:S30-S40. [PMID: 37696014 PMCID: PMC10503111 DOI: 10.1097/fch.0000000000000372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
Abstract
Psychosocial stressors have been implicated in childhood obesity, but the role of racism-related stressors is less clear. This study explored associations between neighborhood inequities, discrimination/harassment, and child body mass index (BMI). Parents of children aged 5-9 years from diverse racial/ethnic backgrounds (n = 1307), completed surveys of their child's exposure to discrimination/harassment. Census tract data derived from addresses were used to construct an index of concentration at the extremes, a measure of neighborhood social polarization. Child's height and weight were obtained from medical records. Multiple regression and hierarchical models examined child's BMI and racism at the individual and census tract levels. Children residing in the most Black-homogenous census tracts had 8.2 percentage units higher BMI percentile (95% confidence interval, 1.5-14.9) compared with white-homogenous tracts (P = .03). Household income and home values were lower, poverty rates higher, and single parent households more common among Black-homogeneous census tracts. Almost 30% of children experienced discrimination/harassment in the past year, which was associated with a 5.28-unit higher BMI percentile (95% confidence interval, 1.72-8.84; P = .004). Discrimination and racial/economic segregation were correlated with higher child BMI. Longitudinal studies are needed to understand whether these factors may be related to weight gain trajectories and future health.
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Affiliation(s)
- Alicia Kunin-Batson
- Department of Pediatrics and Center for Pediatric Obesity Medicine, University of Minnesota Medical School, Minneapolis, Minnesota
| | | | | | - Amanda Trofholz
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, Minnesota
| | - Michael F. Troy
- Children’s Minnesota, Minneapolis, Minnesota; Health Policy & Management, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Rachel Hardeman
- Center for Antiracism Research for Health Equity, University of Minnesota, Minneapolis, Minnesota
| | - Jerica M. Berge
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, Minnesota
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Yazdanpanah O, Benjamin DJ, Rezazadeh Kalebasty A. Prostate Cancer in Sexual Minorities: Epidemiology, Screening and Diagnosis, Treatment, and Quality of Life. Cancers (Basel) 2023; 15:cancers15092654. [PMID: 37174119 PMCID: PMC10177609 DOI: 10.3390/cancers15092654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 05/02/2023] [Accepted: 05/04/2023] [Indexed: 05/15/2023] Open
Abstract
Prostate cancer has the highest incidence among all cancers in men. Sexual minorities, including gay and bisexual men, as well as transgender, were previously a "hidden population" that experienced prostate cancer. Although there continues to remain a paucity of data in this population, analyses from studies do not reveal whether this population is more likely to endure prostate cancer. Nonetheless, several qualitative and quantitative studies have established worse quality-of-life outcomes for sexual minorities following prostate cancer treatment. Increased awareness of this previously "hidden population" among healthcare workers, as well as more research, is warranted to gain further understanding on potential disparities faced by this growing population.
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Affiliation(s)
- Omid Yazdanpanah
- Division of Hematology and Oncology, Department of Medicine, UC Irvine Medical Center, Orange, CA 92868, USA
| | | | - Arash Rezazadeh Kalebasty
- Division of Hematology and Oncology, Department of Medicine, UC Irvine Medical Center, Orange, CA 92868, USA
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Cuevas AG, Mann FD, Krueger RF. Discrimination Exposure and Polygenic Risk for Obesity in Adulthood: Testing Gene-Environment Correlations and Interactions. Lifestyle Genom 2023; 16:90-97. [PMID: 36750036 PMCID: PMC11078300 DOI: 10.1159/000529527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 02/01/2023] [Indexed: 02/09/2023] Open
Abstract
INTRODUCTION Exposure to discrimination has emerged as a risk factor for obesity. It remains unclear, however, whether the genotype of the individual can modulate the sensitivity or response to discrimination exposure (gene × environment interaction) or increase the likelihood of experiencing discrimination (gene-environment correlation). METHODS This was an observational study of 4,102 white/European Americans in the Health and Retirement Study with self-reported, biological assessments, and genotyped data from 2006 to 2014. Discrimination was operationalized using the average of nine Everyday Discrimination Scale items. Polygenic risk scores (PRSs) for body mass index (BMI) and waist circumference (WC) were calculated using the weighted sum of risk alleles based on studies conducted by the Genetic Investigation of Anthropometric Traits (GIANT) consortium. RESULTS We found that greater PRS-BMI was significantly associated with more reports of discrimination (β = 0.04 ± 0.02; p = 0.037). Further analysis showed that measured BMI partially mediated the association between PRS-BMI and discrimination. There was no evidence that the association between discrimination and BMI, or the association between discrimination and WC, differed by PRS-BMI or PRS-WC, respectively. CONCLUSION Our findings suggest that individuals with genetic liability for obesity may experience greater discrimination in their lifetime, consistent with a gene-environment correlation hypothesis. There was no evidence of a gene-environment interaction. More genome-wide association studies in diverse populations are needed to improve generalizability of study findings. In the meantime, prevention and clinical intervention efforts that seek to reduce exposure to all forms of discrimination may help reduce obesity at the population level.
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Affiliation(s)
- Adolfo G. Cuevas
- Department of Social and Behavioral Sciences Department, School of Global Public Health, New York University
| | - Frank D. Mann
- Department of Family, Population, and Preventative Medicine, Program in Public Health, Stony Brook University
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Assessment of motivating and demotivating factors to undergo bariatric surgery in high-risk populations with correlation to generalized anxiety disorder and influence of others: a cross-sectional study. Ann Med Surg (Lond) 2023; 85:140-145. [PMID: 36845774 PMCID: PMC9949805 DOI: 10.1097/ms9.0000000000000204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 12/25/2022] [Indexed: 02/28/2023] Open
Abstract
Very few research have looked at the causes and influences that push individuals into bariatric surgery. Although bariatric surgery is effective in boosting self-esteem, little is known about the precise physical characteristics people want to alter. Methods This study was a descriptive, correlational cross-sectional study to achieve the objectives of the study. All overweight and obese population in Jeddah, Saudi Arabia. Study instrument was designed based on the data present in the latest literature. Study tool consisted of: (1) sociodemographic data, (2) motives of bariatric surgery, (3) concerns about bariatric surgery, (4) people affecting the decision of seeking bariatric surgery, and (5) general anxiety disorder scale. Results The study included 567 participants. More than half of the study participants were females (n=335, 59.1%). The mean age among study participants was 27.88 years. Most of the participants selected themselves as the main person (n=329). In the second place comes "person who had the surgery" (n=72). A family member was prevalent among 59 participants and a friend among 57 participants. The partner has the least frequency. The most common reason was self-esteem among 26% followed by body image among 20%. The most frequent factor was "I am satisfied with my current weight loss method) among 220 participants followed by "I am afraid of any surgery and will avoid it unless absolutely needed" among 51 participants. Conclusion Bariatric surgery patients want to improve their health and live longer. Several people are dissatisfied with their bodies and seek cosmetic surgery. Patients desire bariatric surgery for their own and their loved ones', physicians', and peers' reasons. This study supports emphasizing the reasons why Jeddah, Saudi Arabia residents choose bariatric surgery and the demotivating issues.
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Ross MW, Rosser BRS, Polter EJ, Bates AJ, Wheldon CW, Haggart R, West W, Kohli N, Konety BR, Mitteldorf D, Talley GKMC, Wright M. Discrimination of Sexual and Gender Minority Patients in Prostate Cancer Treatment: Results from the Restore-1 Study. STIGMA AND HEALTH 2023; 8:85-92. [PMID: 36779009 PMCID: PMC9917961 DOI: 10.1037/sah0000356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This study is the first to quantify experiences of discrimination in treatment undertaken by sexual and gender minority prostate cancer patients. Participants were 192 gay and bisexual and one transgender prostate cancer patients living in the US recruited from North America's largest online cancer support group. In this online survey, discrimination in treatment was measured using the Everyday Discrimination Scale (EDS), adapted for medical settings. Almost half (46%) endorsed at least one item, including 43% that the provider did not listen, 25% that they were talked down to, 20% that they received poorer care than other patients, 19% that the provider acted as superior, and 10% that the provider appeared afraid of them. While most (26.3%) rated the discrimination as "rare" or "sometimes" (EDS=1-3), 20% reported it as more common (EDS≥4). Most attributed the discrimination to their sexual orientation, or to providers being arrogant or too pushed for time. Discrimination was significantly associated with poorer urinary, bowel, and hormonal (but not sexual) EPIC function and bother scores, and with poorer mental health (SF-12). Those who had systemic/combined treatment (versus either radiation only or surgery only) were more likely to report discrimination. This study provides the first evidence that discrimination in prostate cancer treatment, including micro-aggressions, appear a common experience for gay and bisexual patients, and may result in poorer health outcomes.
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Affiliation(s)
- Michael W Ross
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - B R Simon Rosser
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Elizabeth J Polter
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Alex J Bates
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Christopher W Wheldon
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, USA
| | - Ryan Haggart
- Department of Urology, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - William West
- Department of Writing Studies, University of Minnesota, Minneapolis, Minnesota, USA
| | - Nidhi Kohli
- Department of Educational Psychology, University of Minnesota, Minneapolis, Minnesota, USA
| | | | | | - G Kristine M C Talley
- Adult and Gerontological Health, University of Minnesota School of Nursing School, Minneapolis, Minnesota, USA
| | - Morgan Wright
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
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Plummer RS, Alter Z, Lee RM, Gordon AR, Cory H, Brion-Meisels G, Reiner J, Topping K, Kenney EL. "It's Not the Stereotypical 80s Movie Bullying": A Qualitative Study on the High School Environment, Body Image, and Weight Stigma. THE JOURNAL OF SCHOOL HEALTH 2022; 92:1165-1176. [PMID: 35702896 PMCID: PMC10137145 DOI: 10.1111/josh.13203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 03/09/2022] [Accepted: 04/07/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Schools are crucial for preventing negative health outcomes in youth and are an ideal setting to address weight stigma and poor body image. The current study sought to examine and describe the nature of weight stigma and body image in adolescents, ascertain aspects of the school environment that affect body image, and identify recommendations for schools. METHODS We conducted 24 semi-structured interviews with students at 2 high schools in 2020. Qualitative data were analyzed using inductive coding and an immersion/crystallization approach. RESULTS Students did not report weight discrimination or harmful body image messaging from teachers or administrators. Physical education (PE) class and dress codes were 2 instances where covert weight stigma appeared. The most common forms of peer weight stigma reported were weight-based teasing and self-directed appearance critiques. Students recommended that schools eliminate dress codes, diversify PE activities, address body image issues in school, and be cognizant of teasing within friend groups. CONCLUSIONS Weight stigma presents itself in unique ways in high school settings. Schools can play a role in reducing experiences of weight stigma and negative body image. Weight-related teasing within friend groups was common and may not be captured in traditional assessments of bullying. More nuanced survey instruments may be needed.
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Affiliation(s)
- Rachel S. Plummer
- Department of Nutrition, Harvard T. H. Chan School of Public Health, 665 Huntington Ave, Boston, MA, 02115
| | - Zanny Alter
- Harvard Graduate School of Education, 13 Appian Way, Cambridge, MA, 02138
| | - Rebekka M. Lee
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115
| | - Allegra R. Gordon
- Department of Community Health Sciences, Boston University School of Public Health, 715AlbanySt, Boston, MA, 02118; Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, MA; Department of Pediatrics, Harvard Medical School, 300 Longwood Ave, Boston, MA, 02115
| | - Hannah Cory
- Department of Nutrition, Harvard T. H. Chan School of Public Health, 665 Huntington Ave, Boston, MA, 02115
| | | | - Jennifer Reiner
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115
| | - Kimm Topping
- Harvard Graduate School of Education, 13 AppianWay, Cambridge, MA, 02138
| | - Erica L. Kenney
- Department of Nutrition, Harvard T. H. Chan School of Public Health, 665 Huntington Ave, Boston, MA, 02115; Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115
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Lee DS, Nitsche N, Barclay K. Body mass index in early adulthood and transition to first birth: Racial/ethnic and sex differences in the United States NLSY79 Cohort. POPULATION STUDIES 2022:1-21. [DOI: 10.1080/00324728.2022.2128396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
| | | | - Kieron Barclay
- Max Planck Institute for Demographic Research
- Swedish Collegium for Advanced Study
- Stockholm University
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Hoffmann K, Paczkowska A, Bryl W, Marzec K, Raakow J, Pross M, Berghaus R, Nowakowska E, Kus K, Michalak M. Comparison of Perceived Weight Discrimination between Polish and German Patients Underwent Bariatric Surgery or Endoscopic Method versus Conservative Treatment for Morbid Obesity: An International Multicenter Study. Nutrients 2022; 14:nu14132775. [PMID: 35807955 PMCID: PMC9268827 DOI: 10.3390/nu14132775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 06/29/2022] [Accepted: 07/02/2022] [Indexed: 02/04/2023] Open
Abstract
Objectives: The aim of this study was to compare the level of discrimination among patients with obesity living in Poland and Germany. Methods: This was a retrospective cross-sectional international multicenter survey study including 564 adult participants treated for morbid obesity at selected healthcare facilities in Germany (210 patients) and in Poland (354 patients). Discrimination was evaluated using a custom-made questionnaire based on the related literature. Results: The level of obesity discrimination did not differ between German and Polish patients (p = 0.4282). The presence of obesity was reported to be associated to a large or a very large extent with the feeling of social exclusion and discrimination by 46.63% of German participants and 42.09% of Polish ones (p = 0.2934). The mean level of discrimination related to the lack of employment was higher in patients who underwent bariatric surgery or endoscopic method than in those who underwent conservative treatment (for Germany: 2.85 ± 1.31 (median, 3) vs. 2.08 ± 1.31 (median, 1), p = 0.002; for Poland: 2.43 ± 1.15 (median, 2) vs. 1.93 ± 1.15 (median, 1), p = 0.005). The level of discrimination was associated with sex, age, the degree of obesity, and treatment-related weight loss (p < 0.05). Conclusions: Our findings confirm that obesity significantly affects the social and economic well-being of patients. There is a great need to reduce weight stigma and to take measures to alleviate the socioeconomic and psychological burden of obesity.
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Affiliation(s)
- Karolina Hoffmann
- Department of Internal Diseases, Metabolic Disorders and Arterial Hypertension, Poznan University of Medical Sciences, 60-806 Poznań, Poland;
- Correspondence: ; Tel.: +48-61-8549-377; Fax: +48-61-8478-529
| | - Anna Paczkowska
- Department of Pharmacoeconomics and Social Pharmacy, Poznan University of Medical Sciences, 60-806 Poznań, Poland; (A.P.); (K.M.); (K.K.)
| | - Wiesław Bryl
- Department of Internal Diseases, Metabolic Disorders and Arterial Hypertension, Poznan University of Medical Sciences, 60-806 Poznań, Poland;
| | - Kinga Marzec
- Department of Pharmacoeconomics and Social Pharmacy, Poznan University of Medical Sciences, 60-806 Poznań, Poland; (A.P.); (K.M.); (K.K.)
| | - Jonas Raakow
- Department of Surgery, Campus Charité Mitte, Campus Virchow Klinikum, Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany;
| | - Matthias Pross
- Department of Surgery, DRK Kliniken Berlin, Köpenick, 12559 Berlin, Germany; (M.P.); (R.B.)
| | - Rafael Berghaus
- Department of Surgery, DRK Kliniken Berlin, Köpenick, 12559 Berlin, Germany; (M.P.); (R.B.)
| | - Elżbieta Nowakowska
- Department of Pharmacology and Toxicology, Institute of Health Sciences, Collegium Medicum, University of Zielona Góra, 65-516 Zielona Góra, Poland;
| | - Krzysztof Kus
- Department of Pharmacoeconomics and Social Pharmacy, Poznan University of Medical Sciences, 60-806 Poznań, Poland; (A.P.); (K.M.); (K.K.)
| | - Michał Michalak
- Department of Computer Science and Statistics, Poznan University of Medical Sciences, 60-806 Poznań, Poland;
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Miller HN, Perrin N, Thorpe RJ, Evans MK, Zonderman AB, Allen J. The Association Between Perceived Discrimination and BMI Trajectory: A Prospective Study of African American and White Adults. FAMILY & COMMUNITY HEALTH 2022; 45:206-213. [PMID: 35385415 PMCID: PMC9156529 DOI: 10.1097/fch.0000000000000326] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Evidence suggests that socioenvironmental stressors, such as discrimination, may serve as determinants of the ongoing obesity epidemic and persisting disparities in obesity prevalence. The objectives of these analyses were to examine whether perceived discrimination was associated with body mass index (BMI) trajectory and whether this relationship differed by race or sex. Data for these analyses came from the Healthy Aging in Neighborhoods of Diversity across the Life Span study, a prospective cohort study in Baltimore City. Mixed-effects linear regression was used in a sample of 1962 African American and white adults to test our hypotheses. We found that race was an effect modifier in the relationship between perceived discrimination and BMI trajectory (B = 0.063, P = .014). Specifically, higher baseline perceived discrimination was associated with positive BMI trajectory in African American adults (B = 0.031, P = .033) but not in white adults (B = -0.032 P = .128). In this longitudinal study of African American and white adults, the relationship between perceived discrimination and BMI trajectory differed by race. Future research should be conducted in diverse samples to understand the risk socioenvironmental stressors pose on the development and progression of overweight and obesity, in addition to how these differ in subgroups.
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Affiliation(s)
- Hailey N Miller
- School of Nursing, Duke University, Durham, North Carolina (Dr Miller); School of Nursing (Drs Perrin and Allen) and Bloomberg School of Public Health (Dr Thorpe), Johns Hopkins University, Baltimore, Maryland; and Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Baltimore, Maryland (Drs Evans and Zonderman)
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McAloon T, Coates V, Fitzsimons D. Duty of care trumps utilitarianism in multi-professional obesity management decisions. Nurs Ethics 2022; 29:1401-1414. [PMID: 35623624 PMCID: PMC9527366 DOI: 10.1177/09697330221075764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Background Escalating levels of obesity place enormous and growing demands on Health
care provision in the (U.K.) United Kingdom. Resources are limited with
increasing and competing demands upon them. Ethical considerations underpin
clinical decision making generally, but there is limited evidence regarding
the relationship between these variables particularly in terms of treating
individuals with obesity. Research aim To investigate the views of National Health Service (NHS) clinicians on
navigating the ethical challenges and decision making associated with
obesity management in adults with chronic illness. Research design A cross-sectional, multi-site survey distributed electronically. Participants A consensus sample of nurses, doctors, dietitians and final year students in
two NHS Trusts and two Universities. Ethical considerations Ethical and governance approvals obtained from a National Ethics Committee
(11NIR035), two universities and two teaching hospitals. Results Of the total (n = 395) participants, the majority were
nurses (48%), female (79%) and qualified clinicians (59%). Participants
strongly considered the individual to have primary responsibility for a
healthy weight and an obligation to attempt to maintain that healthy weight
if they wish to access NHS care. Yet two thirds would not withhold treatment
for patients with obesity. Discussion While clinicians were clear about patient responsibility and obligations, the
majority prioritised their duty of care and would not invoke a utilitarian
approach to decision making. This may reflect awareness of obesity as a
multi-faceted entity, with responsibility for support and management shared
amongst society in general. Conclusions The attitudes of this sample of clinicians complemented the concept of the
health service as being built on a principle of community, with each treated
according to their need. However limited resources challenge the concept of
needs-based decisions consequently societal engagement is necessary to agree
a pragmatic way forward.
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Affiliation(s)
- Toni McAloon
- Department of Nursing, 42259Ulster University - Jordanstown Campus, Newtownabbey, UK
| | - Vivien Coates
- Department of Nursing, 2596Ulster University - Coleraine Campus, Coleraine, UK
| | - Donna Fitzsimons
- Department of Nursing, 1596Queen's University Belfast, Belfast, UK
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14
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Bray B, Bray C, Bradley R, Zwickey H. Binge Eating Disorder Is a Social Justice Issue: A Cross-Sectional Mixed-Methods Study of Binge Eating Disorder Experts' Opinions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:6243. [PMID: 35627779 PMCID: PMC9141064 DOI: 10.3390/ijerph19106243] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/14/2022] [Accepted: 05/17/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Binge eating disorder is an autonomous DSM-V diagnosis characterized by discrete rapid consumption of objectively large amounts of food without compensation, associated with loss of control and distress. Environmental factors that contribute to binge eating disorder continue to evolve. This mixed-methods cross-sectional study assessed whether there is consensus among experts in the field about environmental factors that influence adult binge eating disorder pathology. METHODS Fourteen expert binge eating disorder researchers, clinicians, and healthcare administrators were identified internationally based on federal funding, PubMed-indexed publications, active practice in the field, leadership in relevant societies, and/or clinical and popular press distinction. Semi-structured interviews were recorded anonymously and analyzed by ≥2 investigators using reflexive thematic analysis and quantification. RESULTS Identified themes included: (1) systemic issues and systems of oppression (100%); (2) marginalized and under-represented populations (100%); (3) economic precarity and food/nutrition insecurity/scarcity (93%); (4) stigmatization and its psychological impacts (93%); (5) trauma and adversity (79%); (6) interpersonal factors (64%); (7) social messaging and social media (50%); (8) predatory food industry practices (29%); and (9) research/clinical gaps and directives (100%). CONCLUSIONS Overall, experts call for policy changes around systemic factors that abet binge eating and for greater public education about who can have binge eating disorder. There is also a call to take and account for the narratives and life experiences of individuals with binge eating disorder to better inform our current understanding of the diagnosis and the environmental factors that impact it.
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Affiliation(s)
- Brenna Bray
- Helfgott Research Institute, National University of Natural Medicine, Portland, OR 97201, USA; (R.B.); (H.Z.)
| | - Chris Bray
- Wilder Research Division, Amherst H. Wilder Foundation, Saint Paul, MN 55104, USA;
| | - Ryan Bradley
- Helfgott Research Institute, National University of Natural Medicine, Portland, OR 97201, USA; (R.B.); (H.Z.)
- Herbert Wertheim School of Public Health, University of California, San Diego, CA 97037, USA
| | - Heather Zwickey
- Helfgott Research Institute, National University of Natural Medicine, Portland, OR 97201, USA; (R.B.); (H.Z.)
- Herbert Wertheim School of Public Health, University of California, San Diego, CA 97037, USA
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15
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Marshall TA, Curtis AM, Cavanaugh JE, Warren JJ, Levy SM. Associations between body mass index and body composition measures in a birth cohort. Pediatr Res 2022; 91:1606-1615. [PMID: 33972687 PMCID: PMC8578575 DOI: 10.1038/s41390-021-01562-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 04/15/2021] [Accepted: 04/20/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Associations among body composition measures have been limited to cross-sectional analyses of different subjects. We identified cross-sectional relationships between body mass index (BMI) and other body composition measures and predicted body composition measures from BMI throughout childhood and adolescence. METHODS BMI was calculated and % body fat (%BF), fat mass index (FMI), and fat-free mass index (FFMI) were measured using dual-energy x-ray absorptiometry at ages 5, 9, 11, 13, 15, and 17 years in a birth cohort (n = 629). Sex-specific body composition measures were calculated for BMI-for-age percentiles; associations between BMI and body composition measures were characterized; and body composition measures were predicted from BMI. RESULTS %BF, FMI, and FFMI generally increased with BMI-for-age percentiles at each age. Correlations between BMI and %BF or FMI were generally higher at BMI-for-age percentiles ≥95% than for lower BMI-for-age percentiles. Correlations between BMI and FFMI were generally higher for participants at very low and very high BMI-for-age percentiles than at moderate BMI-for-age percentiles. Age- and sex-specific predictions from BMI are provided for %BF, FM, and FFMI. CONCLUSIONS Sex-specific body composition measures throughout childhood and adolescence are presented. BMI is a better indicator of adiposity at higher than at lower BMI values. IMPACT Sex-specific body composition measures throughout childhood and adolescence are described. % BF, FMI, and FFMI generally increased with BMI-for-age percentiles for both sexes throughout childhood and adolescence. BMI is a better indicator of adiposity at higher BMI levels than at lower BMI values throughout childhood and adolescence.
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16
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Li P, Chen X, Stafford F, Ou J. Body shape and stable employment opportunity analysis of China's nonagricultural labor market. SSM Popul Health 2022; 17:101014. [PMID: 35024421 PMCID: PMC8733337 DOI: 10.1016/j.ssmph.2021.101014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 12/11/2021] [Accepted: 12/20/2021] [Indexed: 10/31/2022] Open
Abstract
Based on the integrated data of the China General Social Survey (CGSS) from 2010 to 2017, this study observes that body shape - being overweight or underweight - is important for labor market outcomes. Body shape significantly affects the employment opportunities of Chinese individuals, and this effect differs by gender and across the occupational hierarchy. Women face both slim premium and obesity penalty effects. Slim women, those with normal and lower but not excessively lower body weight, are more likely to gain long-term employment contracts in the labor market, while the opposite is observed for overweight individuals. The relationship between women's body shape and employment opportunities also varies by occupation. The obesity penalty is more pronounced in occupations with a higher International Socio-Economic Index (ISEI), while the slim premium is more evident in occupations with a low ISEI. The results suggest that the Chinese labor market is highly demanding regarding women's figures, while it is relatively tolerant of men's figures. By mechanism analysis, health capital is found to be the leading cause of the body shape effect. In addition, socialization is also a possible pathway of action. This paper has extended implications for the study of stature and employment stability, enriching the empirical research on labor market discrimination.
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Affiliation(s)
- Ping Li
- Associate Professor of Economics, School of Economics and Management, South China Normal University, Guangzhou, 510006, China
| | - Xiaozhou Chen
- Associate Professor of Economics, School of Business Administration, Guangdong University of Finance, Guangzhou, 510006, China
| | - Frank Stafford
- Professor of Economics, Department of Economics and Institute for Social Research, University of Michigan, Ann arbor, Michigan, 48108, United States
| | - Jinyun Ou
- Ph.D. Candidate, School of Economics and Management, South China Normal University, Guangzhou, 510006, China
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17
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Merriwether EN, Wittleder S, Cho G, Bogan E, Thomas R, Bostwick N, Wang B, Ravenell J, Jay M. Racial and weight discrimination associations with pain intensity and pain interference in an ethnically diverse sample of adults with obesity: a baseline analysis of the clustered randomized-controlled clinical trial the goals for eating and moving (GEM) study. BMC Public Health 2021; 21:2201. [PMID: 34856961 PMCID: PMC8638106 DOI: 10.1186/s12889-021-12199-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 10/18/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Everyday experiences with racial (RD) and weight discrimination (WD) are risk factors for chronic pain in ethnically diverse adults with obesity. However, the individual or combined effects of RD and WD on pain in adults with obesity is not well understood. There are gender differences and sexual dimorphisms in nociception and pain, but the effect of gender on relationships between RD, WD, and pain outcomes in ethnically diverse adults with obesity is unclear. Thus, the purposes of this study were to: 1) examine whether RD and WD are associated with pain intensity and interference, and 2) explore gender as a moderator of the associations between RD, WD, and pain. METHODS This is a baseline data analysis from a randomized, controlled clinical trial of a lifestyle weight-management intervention. Eligible participants were English or Spanish-speaking (ages 18-69 years) and had either a body mass index of ≥30 kg/m2 or ≥ 25 kg/m2 with weight-related comorbidity. RD and WD were measured using questions derived from the Experiences of Discrimination questionnaire (EOD). Pain interference and intensity were measured using the PROMIS 29 adult profile V2.1. Linear regression models were performed to determine the associations between WD, RD, gender, and pain outcomes. RESULTS Participants (n = 483) reported mild pain interference (T-score: 52.65 ± 10.29) and moderate pain intensity (4.23 ± 3.15). RD was more strongly associated with pain interference in women (b = .47, SE = .08, p < 001), compared to men (b = .14, SE = .07, p = .06). Also, there were no significant interaction effects between RD and gender on pain intensity, or between WD and gender on pain interference or pain intensity. CONCLUSIONS Pain is highly prevalent in adults with obesity, and is impacted by the frequencies of experiences with RD and WD. Further, discrimination against adults with obesity and chronic pain could exacerbate existing racial disparities in pain and weight management. Asking ethnically diverse adults with obesity about their pain and their experiences of RD and WD could help clinicians make culturally informed assessment and intervention decisions that address barriers to pain relief and weight loss. TRIAL REGISTRATION NCT03006328.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Melanie Jay
- NYU Grossman School of Medicine, New York, USA
- New York Harbor VA, New York, USA
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18
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Puhl RM, Lessard LM, Pearl RL, Himmelstein MS, Foster GD. International comparisons of weight stigma: addressing a void in the field. Int J Obes (Lond) 2021; 45:1976-1985. [PMID: 34059785 DOI: 10.1038/s41366-021-00860-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 04/22/2021] [Accepted: 05/06/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND/OBJECTIVES Despite substantial evidence documenting weight stigma toward people with higher body weight, international comparative studies are lacking in this field. The few studies that have compared weight stigma across different countries focus on explicit weight-biased attitudes rather than people's experiences of weight stigma. The present study conducted a multinational systematic comparison of weight stigma in six countries to assess experiences and interpersonal sources of weight stigma. SUBJECTS/METHODS Adults (N = 13,996) enrolled in WW International (formerly Weight Watchers), residing in Australia, Canada, France, Germany, the UK, and the US completed identical online anonymous surveys in the dominant language for their country. Surveys assessed their history of experiencing weight stigma, the onset of stigmatizing experiences and associated distress from stigma in different time periods, and interpersonal sources of weight stigma. RESULTS More than half of participants (55.6-61.3%) across countries reported experiencing weight stigma. Participants with higher BMI were significantly more likely to report weight-stigmatizing experiences than individuals with lower BMI. In all countries, weight stigma experiences were most frequent in childhood and adolescence, with associated distress highest during these time periods. Participants in Germany reported a higher frequency of weight stigma across their whole life, but lower distress associated with stigmatizing experiences, compared to participants in the other five countries. High percentages of participants in each country experienced weight stigma from family members (76.0-87.8%), classmates (72.0-80.9%), doctors (62.6-73.5%), co-workers (54.1-61.7%), and friends (48.8-66.2%). CONCLUSIONS Weight stigma is prevalent for adults actively engaged in weight management across different Western countries. There were more similarities than differences in the nature, frequency, and interpersonal sources of people's experiences of weight stigma across the six countries in this study. Findings underscore the need for multinational initiatives to address weight stigma and interventions to support individuals engaged in weight management who experience weight mistreatment.
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Affiliation(s)
- Rebecca M Puhl
- Department of Human Development & Family Sciences, University of Connecticut, Storrs, CT, USA. .,Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, CT, USA.
| | - Leah M Lessard
- Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, CT, USA
| | - Rebecca L Pearl
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.,Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Mary S Himmelstein
- Department of Psychological Sciences, Kent State University, Kent, OH, USA
| | - Gary D Foster
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.,WW International, Inc., New York, NY, USA
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19
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The Conceptualization of Everyday Racism in Research on the Mental and Physical Health of Ethnic and Racial Groups: a Systematic Review. J Racial Ethn Health Disparities 2020; 8:648-660. [DOI: 10.1007/s40615-020-00824-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 06/23/2020] [Accepted: 07/14/2020] [Indexed: 10/23/2022]
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20
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Craig H, le Roux C, Keogh F, Finucane FM. How Ethical Is Our Current Delivery of Care to Patients with Severe and Complicated Obesity? Obes Surg 2019; 28:2078-2082. [PMID: 29766353 PMCID: PMC6018590 DOI: 10.1007/s11695-018-3301-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Despite overwhelming evidence that bariatric interventions reduce morbidity and mortality and are cost-effective, access for affected patients is limited. We sought to describe the extent to which health policy makers and publically funded health services have an ethical obligation to provide bariatric care. We conducted a narrative review of the literature pertaining to the efficacy, safety, and cost-effectiveness of bariatric surgical interventions, in the context of the core principles of medical ethics. We found that in relation to autonomy (i.e., the right to self-determination), beneficence, non-maleficence, and justice (i.e., the obligation to provide fair and equitable treatment to all patients), the current provision of bariatric surgical care fell short of meeting internationally recognized medical ethical standards. These findings have important implications for government policy and healthcare resource allocation. Respecting the individual’s right of self-determination, to do good, prevent harm, and provide equity in access to services is paramount, even when that individual is obese.
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Affiliation(s)
- Hilary Craig
- Department of Surgery, St. James's Hospital, Dublin, Ireland
| | - Carel le Roux
- Diabetes Complications Research Centre, Conway Institute, University College Dublin, Dublin, Ireland
| | - Fiona Keogh
- Centre for Economic and Social Research in Dementia, National University of Ireland, Galway, Ireland
| | - Francis M Finucane
- Bariatric Medicine Service and HRB Clinical Research Facility, Galway University Hospital and National University of Ireland, Galway, Ireland.
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21
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Pearl RL, Wadden TA, Walton K, Allison KC, Tronieri JS, Williams NN. Health and appearance: Factors motivating the decision to seek bariatric surgery. Surg Obes Relat Dis 2019; 15:636-642. [PMID: 30803880 DOI: 10.1016/j.soard.2019.01.015] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 12/19/2018] [Accepted: 01/21/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND Few studies have examined the motivating factors and people that lead patients to seek bariatric surgery. Bariatric surgery helps to improve body image, but little is known about patients' desired changes in the appearance of specific body parts. OBJECTIVES To identify key factors and people motivating patients' decision to seek bariatric surgery, and to assess body dissatisfaction and desire for surgery to change the appearance of specific body parts. SETTING U.S. university-based hospital clinic. METHODS Patients seeking bariatric surgery (N = 208, 78.4% women, 52.4% black, mean age = 42.0 ± 12.3 yr, mean body mass index = 46.7 ± 8.5 kg/m2) completed the Reasons for Bariatric Surgery questionnaire before their preoperative Psychosocial-behavioral evaluation. Participants rated (1-10) the importance of 15 potential reasons and 7 potential people motivating their decision to seek bariatric surgery. Participants also rated their dissatisfaction and desire for surgery to change the appearance of 11 body parts. RESULTS Mean scores of motivating factors were highest for Physical Health (9.9 ± .4), followed by Longevity (9.7 ± .9). Patients reported high body dissatisfaction and desire for surgery to change the appearance of several body parts, including stomach and thighs. "Myself" was the highest-rated motivating person, followed by healthcare providers, family, and someone who had undergone bariatric surgery. CONCLUSIONS Health is the primary reason reported by patients for seeking bariatric surgery. Patients also report a strong desire for surgery to change the appearance of their body. Patients are self-driven to pursue surgery but are also influenced by healthcare providers, family, and people who have undergone surgery. (Surg Obes Relat Dis 2019;X:XXX-XXX.) © 2019 American Society for Metabolic and Bariatric Surgery. All rights reserved.
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Affiliation(s)
- Rebecca L Pearl
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania; Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
| | - Thomas A Wadden
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Kaylah Walton
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Kelly C Allison
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jena Shaw Tronieri
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Noel N Williams
- Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
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22
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Phelan SM. An update on research examining the implications of stigma for access to and utilization of bariatric surgery. Curr Opin Endocrinol Diabetes Obes 2018; 25:321-325. [PMID: 30048259 DOI: 10.1097/med.0000000000000431] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
PURPOSE OF REVIEW To summarize recent literature examining the relationship between stigma and utilization of surgical treatments for obesity. RECENT FINDINGS The stigma of obesity and stigma associated with surgical treatments for obesity can affect both healthcare providers' recommendations of these options and patients' likelihood of considering and choosing these treatments. Presurgical requirements of healthcare and insurance organizations and a lack of postsurgical support reflect the stigmatizing attitudes that bariatric/metabolic surgery is an 'easy fix' and 'last resort' for patients too undisciplined to lose weight in other ways. SUMMARY Here we review the literature published in the last year that addresses the implications of stigma for the utilization and outcomes of surgical treatments for obesity.
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Affiliation(s)
- Sean M Phelan
- Division of Healthcare Policy and Research, Mayo Clinic, Rochester, Minnesota, USA
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