“… Sidebar: Bariatric surgery considerations for South and Southeast AsiaAccess to bariatric surgery is increasing across the Asia‐Pacific region 191,211 . Significant barriers to uptake remain, including limited public insurance coverage, patients' fears and misconceptions, and a lack of acceptance of the need for surgery 191,212,213 . Even among healthcare professionals, low awareness of bariatric surgery options and safety leads to low referral rates in South and Southeast Asian countries, 191 as has been reported elsewhere 214,215 …”
Section: Resultsmentioning
confidence: 99%
“…Such attitudes may arise from the common but unfounded assumption that people with obesity have poor self‐control or present a high risk of treatment nonadherence. Surveys in Asian, including South and Southeast Asian, countries suggest that such opinions are common among clinicians and the general public, and that people with obesity are reluctant to engage their doctors in a discussion about their weight 213,239,240 …”
Section: Resultsmentioning
confidence: 99%
“…Surveys in Asian, including South and Southeast Asian, countries suggest that such opinions are common among clinicians and the general public, and that people with obesity are reluctant to engage their doctors in a discussion about their weight. 213,239,240 Internalization of stigma 241 generates a poor self-image, which is difficult to treat but may be easily worsened by a hostile encounter.…”
Summary
Obesity is a chronic disease in which the abnormal or excessive accumulation of body fat leads to impaired health and increased risk of mortality and chronic health complications. Prevalence of obesity is rising rapidly in South and Southeast Asia, with potentially serious consequences for local economies, healthcare systems, and quality of life. Our group of obesity specialists from Bangladesh, Brunei Darussalam, India, Indonesia, Malaysia, Philippines, Singapore, Sri Lanka, Thailand, and Viet Nam undertook to develop consensus recommendations for management and care of adults and children with obesity in South and Southeast Asia. To this end, we identified and researched 12 clinical questions related to obesity. These questions address the optimal approaches for identifying and staging obesity, treatment (lifestyle, behavioral, pharmacologic, and surgical options) and maintenance of reduced weight, as well as issues related to weight stigma and patient engagement in the clinical setting. We achieved consensus on 42 clinical recommendations that address these questions. An algorithm describing obesity care is presented, keyed to the various consensus recommendations.
“… Sidebar: Bariatric surgery considerations for South and Southeast AsiaAccess to bariatric surgery is increasing across the Asia‐Pacific region 191,211 . Significant barriers to uptake remain, including limited public insurance coverage, patients' fears and misconceptions, and a lack of acceptance of the need for surgery 191,212,213 . Even among healthcare professionals, low awareness of bariatric surgery options and safety leads to low referral rates in South and Southeast Asian countries, 191 as has been reported elsewhere 214,215 …”
Section: Resultsmentioning
confidence: 99%
“…Such attitudes may arise from the common but unfounded assumption that people with obesity have poor self‐control or present a high risk of treatment nonadherence. Surveys in Asian, including South and Southeast Asian, countries suggest that such opinions are common among clinicians and the general public, and that people with obesity are reluctant to engage their doctors in a discussion about their weight 213,239,240 …”
Section: Resultsmentioning
confidence: 99%
“…Surveys in Asian, including South and Southeast Asian, countries suggest that such opinions are common among clinicians and the general public, and that people with obesity are reluctant to engage their doctors in a discussion about their weight. 213,239,240 Internalization of stigma 241 generates a poor self-image, which is difficult to treat but may be easily worsened by a hostile encounter.…”
Summary
Obesity is a chronic disease in which the abnormal or excessive accumulation of body fat leads to impaired health and increased risk of mortality and chronic health complications. Prevalence of obesity is rising rapidly in South and Southeast Asia, with potentially serious consequences for local economies, healthcare systems, and quality of life. Our group of obesity specialists from Bangladesh, Brunei Darussalam, India, Indonesia, Malaysia, Philippines, Singapore, Sri Lanka, Thailand, and Viet Nam undertook to develop consensus recommendations for management and care of adults and children with obesity in South and Southeast Asia. To this end, we identified and researched 12 clinical questions related to obesity. These questions address the optimal approaches for identifying and staging obesity, treatment (lifestyle, behavioral, pharmacologic, and surgical options) and maintenance of reduced weight, as well as issues related to weight stigma and patient engagement in the clinical setting. We achieved consensus on 42 clinical recommendations that address these questions. An algorithm describing obesity care is presented, keyed to the various consensus recommendations.
“…Proper training of physicians and nurses may lead to improved stigmatization and ultimately effective treatment of obesity. Even though it has been shown that bariatric surgery is the most effective treatment for long-term weight loss, the general population was shown to classify surgery as non-effective or not recommended and were furthermore unsure of its risks [59][60][61]. To date, there are only few studies reporting on interventions to reduce weight-related stigmatization [8,62].…”
Background Stigmatization and discrimination of people with obesity due to their weight are a common problem that may lead to additional weight gain. This study evaluated the influence of different parameters on the stigmatization of obesity. Material and Methods Participants of six groups (general population, patients with obesity, medical students, physicians, nurses in training and nurses; n = 490) answered the short-form fat phobia scale (FPS) between August 2016 and July 2017. The influence of body mass index (BMI), gender and other factors on total scores and single adjective pairs was analyzed. Results A total of 490 participants were evaluated. The total mean FPS rating was 3.5 ± 0.6. FPS was significantly lower (more positive) in participants with obesity (3.2 ± 0.7) compared with participants without obesity (3.5 ± 0.5, p < 0.001). Individuals with obesity and diabetes rated the FPS significantly lower (more positive), whereas age and gender did not have a significant influence. Participants with obesity linked obesity more often with good selfcontrol (p < 0.001), being shapely (p = 0.002), industrious (p < 0.001), attractive (p < 0.001), active (p < 0.001), selfsacrificing (p < 0.001) and having more willpower (p < 0.001) than the participants without obesity. Females rated more positive in shapely versus shapeless (p = 0.038) and attractive versus non-attractive (p < 0.001) than males. Conclusions The present study shows that stigmatization of obesity is present in medical professionals as well as the general population. People affected by obesity characterized other people with obesity more positively (e.g. attractive or active), whereas people without obesity linked negative characteristics with obesity. Gender had an influence only on single items of FPS but did not affect overall stigmatization of obesity.
“…Coupled with the belief that the responsibility to manage obesity and weight issues (90 percent) lies solely with PwO, this may contribute to PwO not seeking medical attention as they should. 9 Inadequate healthcare coverage for obesity treatments stemming from misconceptions about PwO and of the disease itself result in high out-of-pocket costs and contribute to the poor uptake of obesity pharmacotherapy despite the need for treatment. 10,11 Weight bias and stigma by healthcare professionals from a variety of reasons has resulted in healthcare professionals not adequately addressing obesity in patients.…”
Obesity is a chronic disease which is often relapsing and progressive due in part to the physiology of energy homeostasis in people with obesity, rendering them with the challenge of attaining adequate weight loss and weight maintenance after successful weight loss. Depending on the presence, types and severity of the obesity-related comorbidities (ORCs), some patients will require an amount of weight loss beyond what lifestyle and behavioural modification can achieve. Even after bariatric surgery, patients may not lose the expected amount of weight or experience weight regain. Anti-obesity medications may be required to support them further. Hence, the use of pharmacotherapy in obesity management remains an important adjunct to lifestyle and behavioural modifications and even to bariatric surgery, particularly in those with more severe ORCs and with a high body mass index. This article discusses the general approach to the use of pharmacotherapy in obesity management and the various anti-obesity medications currently approved.
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