Obesity stigma: A newly recognized barrier to comprehensive and effective type 2 diabetes management

Teixeira, M. Elizabeth; Budd, Geraldine M.

doi:10.1111/j.1745-7599.2010.00551.x

Cited by 70 publications

(52 citation statements)

References 44 publications

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“…Our findings indicate that not only is obesity-related stigma likely to be a barrier to diabetes management in a healthcare setting,34 but also diabetes-specific stigma may be an additional barrier. This was illustrated by the fact that much of what was discussed by participants was specific to have T2DM, and not about being overweight or obese.…”

Section: Discussionmentioning

confidence: 77%

“…Given that the obesity and diabetes stigmas are not one and the same, further research into diabetes-related stigma is required, and we cannot solely rely on the obesity stigma literature to inform future work in diabetes. Considerable research has already been undertaken with regard to understanding, combating or minimising the impact of the obesity stigma in healthcare or health education settings 34 – 37. Similar work is now needed in diabetes, with a view in conducting research that examines the correlates and outcomes of diabetes-related stigma for the person living with the condition, using findings to inform antistigma interventions in healthcare settings, and influencing the way T2DM is portrayed in the media.…”

Section: Discussionmentioning

confidence: 99%

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‘I call it the blame and shame disease’: a qualitative study about perceptions of social stigma surrounding type 2 diabetes

et al. 2013

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ObjectivesWhile health-related stigma has been the subject of considerable research in other conditions (obesity and HIV/AIDS), it has not received substantial attention in diabetes. The aim of the current study was to explore the social experiences of Australian adults living with type 2 diabetes mellitus (T2DM), with a particular focus on the perception and experience of diabetes-related stigma.DesignA qualitative study using semistructured interviews, which were audio recorded, transcribed and subject to thematic analysis.SettingThis study was conducted in non-clinical settings in metropolitan and regional areas in the Australian state of Victoria. Participants were recruited primarily through the state consumer organisation representing people with diabetes.ParticipantsAll adults aged ≥18 years with T2DM living in Victoria were eligible to take part. Twenty-five adults with T2DM participated (12 women; median age 61 years; median diabetes duration 5 years).ResultsA total of 21 (84%) participants indicated that they believed T2DM was stigmatised, or reported evidence of stigmatisation. Specific themes about the experience of stigma were feeling blamed by others for causing their own condition, being subject to negative stereotyping, being discriminated against or having restricted opportunities in life. Other themes focused on sources of stigma, which included the media, healthcare professionals, friends, family and colleagues. Themes relating to the consequences of this stigma were also evident, including participants’ unwillingness to disclose their condition to others and psychological distress. Participants believed that people with type 1 diabetes do not experience similar stigmatisation.ConclusionsOur study found evidence of people with T2DM experiencing and perceiving diabetes-related social stigma. Further research is needed to explore ways to measure and minimise diabetes-related stigma at the individual and societal levels, and also to explore perceptions and experiences of stigma in people with type 1 diabetes.

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Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 99%

‘I call it the blame and shame disease’: a qualitative study about perceptions of social stigma surrounding type 2 diabetes

et al. 2013

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“…In society, there is a stigma often associated with obesity resulting in various negative consequences ranging from disparities in gaining employment, social rejection, negative stereotypes and reduced access to health care (all of which are associated with poorer health outcomes) [39]. This stigmatism is especially true of younger, obese adults, which may explain the differences seen on older, obese adults [40-44]. Therefore, age is an important factor affecting satisfaction in obese individuals, explaining the discrepancy between studies on satisfaction in obese individuals.…”

Section: Discussionmentioning

confidence: 99%

Obese older adults report high satisfaction and positive experiences with care

Bottone

Wang

Hommer

et al. 2014

BMC Health Serv Res

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BackgroundObese, older adults often have multiple chronic conditions resulting in multiple health care encounters. However, their satisfaction and experiences with care are not well understood. The objective of this study was to examine the independent impact of obesity on patient satisfaction and experiences with care in adults 65 years of age and older with Medigap insurance.MethodsSurveys were mailed to 53,286 randomly chosen adults with an AARP® Medicare Supplement Insurance Plan insured by UnitedHealthcare Insurance Company (for New York residents, UnitedHealthcare Insurance Company of New York) in 10 states. Following adjustment for non-response bias, multivariate regression modeling was used to adjust for demographic, socioeconomic and health status differences to estimate the independent impact of weight on satisfaction and experiences with care. Outcome variables included four global and four composite measures of satisfaction and experiences with care.Results21.4% of the respondents were obese. Relative to normal weight, obesity was significantly associated with higher patient satisfaction and better experiences with care in seven of the eight ratings measured.ConclusionsObese individuals were more satisfied and had better experiences with care. Obese individuals had more office visits and discussions about nutrition, exercise and medical checks. This may have led to increased attentiveness to care, explaining the increase in satisfaction and better experiences with care. Given the high level of satisfaction and experiences with care in older, obese adults, opportunities exist for clinicians to address weight concerns in this population.

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“…In addition, many participants attempted to distance themselves or avoid situations in which they feel stigmatised. Research on stigma in diabetes is limited, 25 but it is suggested that such attitudes may lead people with type 2 diabetes to feel guilt and blame for their diabetes. As a result, people with type 2 diabetes may shy away from opportunities for support to avoid such stigma and prejudice, which can potentially act as a barrier to diabetes management.…”

Section: Discussionmentioning

confidence: 99%

Perceived support from family and friends among adults with type 2 diabetes

Oftedal

2014

European Diabetes Nursing

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SummaryThe aim of this study was to describe how adults with type 2 diabetes perceive support provided by family and friends and how such support can influence their diabetes management. Diabetes management behaviours have been described as challenging, and many individuals with type 2 diabetes fail to attain optimal glycaemic control. It has therefore been suggested that support from family and friends is critical for effective diabetes management. However, there is little empirical evidence from a patient perspective of how support provided by family and friends is perceived and how support can influence patients' diabetes management.The study was comprised of a descriptive qualitative design that included three focus groups, which were used to collect data. The sample consisted of 19 adults with type 2 diabetes, and the data was analysed using qualitative content analysis. The findings revealed three themes reflecting perceived support from family and friends: mixed practical support; non-constructive emotional support, and intrusive informational support. Furthermore, the findings indicated that participants' perceived mixed practical support, eg diet and exercise, from family and friends, as helpful and valuable. Thus, this kind of practical support stimulates effective diabetes management. However, many participants reported that they did not receive such support, which in turn, reduced their diabetes regulation efforts. Emotional support was perceived as non-constructive and appears to demotivate participants' diabetes management. Finally, the findings indicated that informational support was perceived as intrusive and did not meet their needs for support in diabetes management.

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Obesity stigma: A newly recognized barrier to comprehensive and effective type 2 diabetes management

Cited by 70 publications

References 44 publications

‘I call it the blame and shame disease’: a qualitative study about perceptions of social stigma surrounding type 2 diabetes

‘I call it the blame and shame disease’: a qualitative study about perceptions of social stigma surrounding type 2 diabetes

Obese older adults report high satisfaction and positive experiences with care

Perceived support from family and friends among adults with type 2 diabetes

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