Endoscopy in the Morbidly Obese: A Case Highlighting Healthcare Inequities

Response to Nassani and El-Khoury

“…We have read with great interest the article "Postobesity surgery esophageal dysfunction: A combined cross-sectional prevalence study and retrospective analysis" by Miller et al (1) in which esophageal function after bariatric surgery was investigated with high-resolution impedance manometry (HRIM). They retrospectively analyzed data from 137 patients either having a history of laparoscopic sleeve gastrectomy/ Roux-en-Y gastric bypass or having to be submitted to bariatric surgery.…”

“…We are thankful to Nassani and El-Khoury for their comments on our published article and for bringing such an important issue to light (1,2).…”

Ending Obesity Stigma and Discrimination: Starting From Healthcare Professionals

“…We read with great interest the article by Bhalla et al (1) published recently in The American Journal of Gastroenterology . We appreciate the authors describing the unfair experiences of patients with severe obesity in the endoscopic treatment process and their proposed safe endoscopy checklist for high-risk groups.…”

“…Although the authors have noble intentions, they are perhaps unaware of some of the unacceptable uses of language. For example, their use of the words "morbidly obese" to describe individuals living with severe obesity is no longer deemed appropriate nor is their use of the word "obese" in multiple places in the text (1).…”

Decreasing Stigmatization of Persons With Higher Weights: When Words Count

“…The article by Bhalla et al (1) presents the challenges they faced in diagnosing and providing optimal care to a patient with a body mass index (BMI) of 92 kg/m 2 . The authors identify stigma, the lack of infrastructure, equipment, training, and data on endoscopy in patients with higher BMI as major healthcare barriers and suggest a systematic approach to performing endoscopy in this population.…”