Physician Respect for Patients with Obesity

Huizinga, Mary Margaret; Cooper, Lisa A.; Bleich, Sara N.; Clark, Jeanne M.; Beach, Mary Catherine

doi:10.1007/s11606-009-1104-8

Cited by 150 publications

(155 citation statements)

References 19 publications

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“…The literature reports a considerable amount of negative and stereotypical attitudes toward obese patients that can be interpreted as decreased respect for obese patients [29,32,33]. This attitude is clearly felt by the patients, influencing them in their behavior and decisions [32,33,34]. Efforts are needed to avoid these deterrents.…”

Section: Discussionmentioning

confidence: 99%

Impact of Body Mass Index on Prognostically Relevant Breast Cancer Tumor Characteristics

Eichholzer

Huang²,

Modlasiak³

et al. 2013

Breast Care

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Background: This study analyzes the association of body mass index (BMI) and prognostically relevant breast cancer (BC) characteristics in a country that has been rather spared of the global obesity epidemic. Patients and Methods: Based on 20-year data (1999-2009, n = 1,414) of the prospective relational BC database of the University Hospital Basel, Switzerland, the associations between BMI, tumor size and stage, histological subtype, grading, hormonal receptor status, HER2 status and ‘triple-negative' status were evaluated. Multivariate analysis considered BMI and patient's age. Results: The association between increasing BMI and the above-mentioned variables were as follows (results described in each case: Beta-coefficient or odds ratio, 95% confidence interval, p value): tumor size, (1) entire cohort: 0.03 (0.01-0.05), p < 0.001, (2) tumor found by self-palpation: 0.05 (0.03-0.07), p < 0.001, (3) tumor found by radiological examination: 0.03 (0-0.07), p = 0.044; advanced TNM stage: 1.16 (1.02-1.31), p = 0.022; histological subtype: 1.04 (0.89-1.22), p = 0.602; unfavorable grading: 1.11 (1.00-1.25), p = 0.057; positive estrogen receptor status: 0.95 (0.83-1.09), p = 0.459; positive HER2 status: 0.92 (0.74-1.15), p = 0.467; presence of a ‘triple-negative' carcinoma: 1.19 (0.93-1.52), p = 0.165. Consideration of only postmenopausal BC patients (n = 1,063) did attenuate the results, but did not change the direction of the associations with BMI. Conclusion: BMI was positively associated with TNM stage, grading and tumor size for tumors that were found by self-detection, as well as for those lesions detected by radiological breast examinations.

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Section: Discussionmentioning

confidence: 99%

Impact of Body Mass Index on Prognostically Relevant Breast Cancer Tumor Characteristics

Eichholzer

Huang²,

Modlasiak³

et al. 2013

Breast Care

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“…Additionally prejudices against obese people may lead to indirect costs, e.g., they might not get a job because of obesity [27]. Puhl and King [25] furthermore stress the worse medical treatment due to stigmatization [28,29], also in education and schooling [30,31]. All these consequences have tangible and intangible aspects that should be taken into account.…”

Section: Health Economic Aspects Regarding Obesitymentioning

confidence: 99%

The costs and consequences of obesity in Germany: a new approach from a prevalence and life-cycle perspective

Effertz

Engel²,

Verheyen³

et al. 2015

Eur J Health Econ

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With the steadily growing health burden of obesity in Germany, the measuring and quantification of its costs and relevant economic consequences have become increasingly important. The usual quantifications via previous cost-of-illness approaches mostly have several weaknesses, e.g., applying "indirect methods" by using "population-attributable fractions" to identify parts of costs that can be accrued to obesity, second using highly aggregated data and third often only displaying part of the costs. This article presents a new approach and a new estimation of the cost and consequences of obesity in Germany using claims data from a German health insurance company. A sample of 146,000 individuals was analyzed with both a prevalence and a life-cycle focus on the cost and consequences of obesity. With additional data sets, we calculate the deaths per year due to obesity, the excess costs per year and several intangible consequences usually referred to as "pain and suffering". Our results show that the cost estimations of obesity in Germany so far have been largely underestimated. The annual direct costs of obesity in Germany amount to approximately €29.39 billion and the indirect costs to an additional €33.65 billion. A total of 102,000 subjects die prematurely each year because of obesity, and there is a significant excess of unemployment, long-term nursing care, and pain and suffering due to obesity. From a lifetime perspective, every obese man is equal to an additional burden of €166,911 and each woman of €206,526 for the social security system in Germany. Obesity due to unhealthy eating is thus about to replace tobacco consumption in terms of costs and consequences as the main hazardous lifestyle factor and thus should be more intensively focussed by public health policy.

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“…It is well documented that health professionals often carry the negative biases of our society toward individuals who are obese [1][2][3]. Cultivating an awareness of our own biases is the best way to avoid acting on them.…”

Section: Commentarymentioning

confidence: 99%