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    I'm doing a bit of research on obesity and surgery and came across this quote... "stigma might prove to be the ultimate barrier to the expansion of bariatric surgery, the stigma needs to be addressed since it may distract from clinical judgment and public health decision-making"
    I really don't understand how stigma can act as a barrier and how it might affect clinical judgement and decisions?? :/
    Thanks a lot!
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    It's about the public perception of obesity and bariatric surgery. From that quote I'm not sure whether the stigma being addressed is for surgery or obesity, but either way it means that people believe they'll be discriminated against due to obesity or due to choosing to have a bariatric surgery.

    I can't give you why they'd feel like that, but that's what I'd understand from that sentence.
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    No idea why anyone would be stigmatised for undergoing bariatric surgery and trying to reduce their obesity? I know it's a fairly extensive measure to take but given that it's limited to severely obese individuals who can't seem to lose weight by other means, I don't see how it can be viewed negatively.
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    Edit: I might have gotten the wrong idea but my post might be helpful for the rest of your research.

    Here's a comment from an article about fatalities of overweight victims in car crashes compared to those of healthy weight but it goes into more general points about why obese patients have a stigma amongst health professionals. Not all of it may be accurate or fully explained but it raises enough point

    (The results showing increased fatalities are) more likely to do with medical treatment, the hearts of obese people will be less able to sustain the mass of adrenaline due to the incident. You have the problem of getting them to a hospital as most ambulances aren't equipped to cope with larger patients. You have triage and since car crashes usually involve multiple people, skinnier people may be treated first as injuries may be more apparent or the paramedics may determine that they have a higher chance of surviving if given treatment for similar injuries.

    Many healthcare professionals see obese and very overweight patients as a strain on the system, they may not wish to treat people as actively if they show that they care little about their own health. Treating obese people is much more difficult when the treatment required is even slightly invasive, for surgeries it's a nightmare. Anaesthesiologists need to pay extra attention because there's a greater chance of something going wrong with the anaesthesia dosage. Surgeons need to maneuver around the fat which makes the job a lot tougher and so the surgery lasts longer. This leads to more scarring and a higher risk of infection. Special equipment may also be required meaning more resources which are taken from elsewhere. Drugs need to be prescribed in larger doses which comes with greater risk of side effects and tolerances developing more quickly.
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    (Original post by MattKneale)
    No idea why anyone would be stigmatised for undergoing bariatric surgery and trying to reduce their obesity? I know it's a fairly extensive measure to take but given that it's limited to severely obese individuals who can't seem to lose weight by other means, I don't see how it can be viewed negatively.
    If I had to guess, I'd say people could associate stigma with surgery and the risks of surgery in general. Or the unpleasantness of how it helps you reduce your weight and the long-term health implications. Just because we think it's much worse for them to be severely overweight doesn't mean they'd see it the same way.
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    (Original post by lalala777)
    I'm doing a bit of research on obesity and surgery and came across this quote... "stigma might prove to be the ultimate barrier to the expansion of bariatric surgery, the stigma needs to be addressed since it may distract from clinical judgment and public health decision-making"
    I really don't understand how stigma can act as a barrier and how it might affect clinical judgement and decisions?? :/
    Thanks a lot!
    As has already been mentioned, it's hard to tell exactly what this stigmatisation is supposed to be about.

    To throw another option into the ring, I might suggest that it's the stigma among medical professionals and managers that obesity is not really a disease, and that we shouldn't be wasting money doing bariatric surgery because these people should just "sort it out themselves." This means that it may be given lower priority when it comes to resource allocation when compared with other conditions which aren't seen to be so much the patient's "fault."
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    I suppose if we want doctors to help prevent disease as well as treat it then it's redundant whether people see obesity as a disease in itself or not. It irrefutably leads to further disease, morbidity and mortality and hence should be a priority. If we don't want doctors preventing disease (I don't know many people following this viewpoint) then all is rosy.
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    From that snippet, i'd say its suggesting bariatric surgery is underused due to stigma regarding having/doing it. That people seem to think dieting is better, regardless of what an objective cost/benefit analysis would suggest.
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    (Original post by MattKneale)
    I suppose if we want doctors to help prevent disease as well as treat it then it's redundant whether people see obesity as a disease in itself or not. It irrefutably leads to further disease, morbidity and mortality and hence should be a priority. If we don't want doctors preventing disease (I don't know many people following this viewpoint) then all is rosy.
    Not to mention the perception of what's expected on the patient's side of the deal. How much should we expect of a patient regarding their own health? And what role should healthcare professionals take in complementing that? Should it be our role to actively encourage patients to lose weight, or to stay in good health? Or should we expect them to do that on their own, and rely on them to ask us if they need advice?
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    (Original post by MattKneale)
    I suppose if we want doctors to help prevent disease as well as treat it then it's redundant whether people see obesity as a disease in itself or not. It irrefutably leads to further disease, morbidity and mortality and hence should be a priority. If we don't want doctors preventing disease (I don't know many people following this viewpoint) then all is rosy.
    But bariatric surgery isn't preventing obesity. It's treating it when it's already happened, even though there are other non-surgical options available (though these are obviously of variable efficacy). Though I suppose you can argue that it's preventing the other pathological consequences of obesity.
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    (Original post by Hype en Ecosse)
    Not to mention the perception of what's expected on the patient's side of the deal. How much should we expect of a patient regarding their own health? And what role should healthcare professionals take in complementing that? Should it be our role to actively encourage patients to lose weight, or to stay in good health? Or should we expect them to do that on their own, and rely on them to ask us if they need advice?
    I suppose that line gets blurred in obese patients depending upon how much they recognise their condition as abnormal and, linked to that, how much they're willing to change.

    I'm not sure you can advocate admitting and forcing an obese person to lose weight and, failing that, operating on them :P It should probably be a combination of different healthcare professionals -- pharmacists, doctors, dietitians. Whoever appears to notice should give them due warning of their state and how they can combat it.

    I'm not necessarily saying it's the sole responsibility a GP should be the one to do so, or a ward doctor if they've been admitted.

    And I suppose weight isn't the be-all-and-end-all, since we already know BMI is a relatively hopeless measure of actual health when looking at an individual as opposed to large populations.

    (Original post by Helenia)
    But bariatric surgery isn't preventing obesity. It's treating it when it's already happened, even though there are other non-surgical options available (though these are obviously of variable efficacy). Though I suppose you can argue that it's preventing the other pathological consequences of obesity.
    That was more my point, I guess. But as above all healthcare professionals should probably be taking a greater role in reducing obesity from an earlier stage rather than treating it further down the line.

    Now I'm just stating the obvious so I'll stop here :P
 
 
 
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