Obesity and discrimination – a systematic review and meta‐analysis of observational studies

Spahlholz, Jenny; Baer, Nadja-Raphaela; König, Hans‐Helmut; Riedel‐Heller, Steffi G.; Luck-Sikorski, Claudia

doi:10.1111/obr.12343

Cited by 320 publications

(268 citation statements)

References 38 publications

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“…Interestingly, the forum posters in our study wrote relatively little about perceived stigmatisation, although it is inherent in statements such as "wanting life as a fatty to end". Many previous studies have demonstrated the extensive and deep-reaching stigmatisation of people with morbid obesity in all social arenas, including healthcare [28].The findings of the present study show that the attainment of this "new life" did not come easily. Rather, the posters' posts on the discussion forum showed an intricate process of negotiation with the healthcare system.…”

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confidence: 48%

Section: Discussionmentioning

confidence: 99%

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Willmer¹,

Salzmann‐Erikson²

2017

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A qualitative analysis of online forum discussions about bariatric surgery. IntroductionObesity (commonly defined as a Body Mass Index (BMI) of 30 and above) has increased rapidly in most of the world's nations during the last few decades. Morbid obesity (commonly defined as a BMI of 40 and above) has also increased, and the results of a recent pooled analysis of 1698 studies showed that the global prevalence of morbid obesity was 0.64% in men and 1.6% in women, translating into 58 million men and 126 million women worldwide [1].Obesity has been shown to be a risk factor for, amongst other things, type 2 diabetes, cardiovascular disease, gallbladder disease, infertility, osteoarthritis and some cancers [2][3][4].There are also strong associations between obesity and some forms of mental ill-health, such as depression and anxiety [5,6]. However, this may be at least partly due to the considerable stigmatization of obesity in Western society [7].Conventional treatment of obesity commonly focuses on decreasing energy intake and/or increasing energy expenditure. However, this approach has been shown to have moderate long-term effects, especially for those with morbid obesity [8]. The difficulty for most individuals lies not in losing clinically meaningful amounts of weight, but rather in maintaining the lower body weight long-term [9].Bariatric surgery (also known as obesity surgery or metabolic surgery) is defined as any surgery performed on the stomach or intestines of a patient with obesity in order to induce weight loss. There are a number of surgical methods and techniques within this concept, the most common of which currently is Roux-en-Y gastric bypass (RYGB) [10]. This procedure involves bypassing the stomach and a portion of the small intestine, and creating a pouch of the proximal part of the duodenum which functions as a new, much smaller, stomach.For individuals with a BMI of 35 or above, bariatric surgery has been shown to be the only method that results in major long-term weight loss, with a mean 25% weight loss after 20 years in RYGB patients. It also results in improvements or even remission of several common comorbidities, such as diabetes and sleep apnea. Patients have also reported improved mental health, although these results remain less clear-cut [11].Before performing the surgery, most operating units require some degree of weight loss, mainly in order to reduce the fat contents of the liver, thereby reducing its size, improving its flexibility and facilitating easier laparoscopic access. This is usually achieved with Low Calorie Diets (LCD) or Very Low Calorie Diets (VLCD), where the patient wholly or partly subsists on meal replacements such as shakes, soups and puddings which provide 600-800 kcal/day [12]. A systematic review and meta-analysis has shown that preoperative weight loss results in shorter operating times and improved weight loss a year after surgery [13].However, not all patients lose the required weight before surgery, despite being prescribed a low calorie or very low calori...

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contrasting

confidence: 48%

Section: Discussionmentioning

confidence: 99%

(Preprint)

Willmer¹,

Salzmann‐Erikson²

2017

Preprint

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“…En un entorno obeso-génico como el de nuestra sociedad actual, donde existe un fácil acceso a los alimentos y donde muchos de estos están altamente procesados, viendo mejoradas sus capacidades sensoriales, la persona con obesidad se ve abocado a una lucha fútil. A pesar de ser una víctima, es criminalizada en su condición, achacándose a su falta de fuerza voluntad o irresponsabilidad, incluso por los propios profesionales sanitarios [65][66][67][68] . CONCLUSIONES Con las proporciones pandémicas alcanzada por la prevalencia de la obesidad, es crucial ser conscientes de los factores que impulsan el riesgo de enfermedad crónica en pacientes con sobrepeso/obesidad.…”

Section: Figura 3 Expansión Del Tejido Adiposo (Adaptado Deunclassified

Fisiopatología de la obesidad: Perspectiva actual

2017

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INTRODUCCIÓNLa obesidad es una de las mayores problemáticas a la que se enfrenta la sociedad en el siglo XXI. Es tal su prevalencia que en el año 2004 se empieza a considerar como una "pandemia del siglo XXI", acuñándose el término "globesidad" en el año 2010 (aceptado por la WHO en 2011) ante la alarmante realidad que arrojan los datos y que no apuntan hacia una mejora de la situación a corto plazo 1,2 . Hasta el año 1997 la Organización Mundial de la Salud (OMS) no empieza a considerar la obesidad una entidad patológica propia 3 , y hasta entrado el año 2013 no lo hace la Asociación Médica Americana (AMA) 4 . La OMS (1997) definió la obesidad como un acumulo excesivo de grasa que perjudica la salud 3 . Aquí se da el primer problema conceptual, ya que dicha definición no indica la cuantía del exceso de grasa, ni hubiera podido hacerlo, al ser una variable individual difícil de cuantificar. Cummings y Schwartz 5 introducen el concepto de carga genética y ambiental que acompaña a esta patología y la define, como una enfermedad oligogénica, cuya expresión puede ser modulada por numerosos genes modificadores que interaccionan entre sí y a su vez con factores ambientales.

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“…On the other side of the coin, the consequences of obesity are clear: fewer and lower-quality job opportunities, lower wages (especially for women) (5) and higher costs of health care (especially those arising from morbid obesity, BMI>35). These negative outcomes on society justify government intervention.…”

Section: On Obesitymentioning

confidence: 99%