Mindset and Communication Barriers in the Diffusion of Bariatric Surgery

Gerö, Dániel; Hulesch, Bors; Bueter, Marco

doi:10.1007/s11883-018-0738-6

Cited by 14 publications

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“…Based on a literature review on mindset and communication barriers towards BS, barriers mainly arise from absent or incorrect information about obesity as chronic disease and its therapy option. 17 Consequences may be inadequate treatment of obesity, underestimation of the risk of severe obesity—and delayed decision‐making on the next therapy escalation.…”

Section: Discussionmentioning

confidence: 99%

“…The belief of being self‐responsible for the obesity is instilled in those patients over years—also by healthcare professionals. 17 , 19 , 20 A recent study from Saudi Arabia revealed that most patients blame low self‐discipline as one of the main reasons for poor adherence to diet and exercise after BS. 21 Hence, every so‐called therapy failure may stoke the feeling of shame, weakness and guilt and maintains the negative spiral of weight gain.…”

Section: Discussionmentioning

confidence: 99%

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Online survey on factors influencing patients' motivation to undergo bariatric surgery

et al. 2021

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Given the worldwide increasing prevalence of severe obesity and considering the amount of scientific evidence demonstrating the beneficial effects of bariatric surgery (BS), it is surprising that only a fraction of patients with obesity undergo BS. We therefore conducted an anonymized online survey among individuals with a history of BS to understand factors influencing the deciding process leading to BS. Respondents were recruited on a voluntary basis from obesity-related social media groups between April and June 2020. The selfdesigned, non-validated questionnaire consisted of 20 questions and was open to any participants with a history of BS. Of 851 participants who started the survey, 665 completed the questionnaire (completion rate of 78.1%). Five years after BS, still 70% of the surveyparticipants were very satisfied or satisfied with the surgical result. However, the majority (73.3%) would have undergone BS earlier. The main motivation to choose BS was related to health status or quality of life. Important characteristics for a bariatric surgeon to obtain patients' trust are "taking time and listen" (74.7%), empathy (64%) and sympathy (56%).Post-operative satisfaction with the surgical outcome was high and long-lasting in this large cohort of BS patients. However, most participants would retrospectively have undergone BS earlier. The main reason to choose BS as treatment for their obesity were impaired physical health or reduced quality of life. Nearby location to patients' residence and availability of surgeons with empathy were decisive motives for bariatric centre selection.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Online survey on factors influencing patients' motivation to undergo bariatric surgery

et al. 2021

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“…Bezogen auf die Einwohnerzahl war das Missverhältnis zwischen effektiven Patientenzahlen und tatsächlich durchgeführten bariatrischen Eingriffen in Deutschland jahrelang besonders auffällig [ 2 , 4 ]. Unzweifelhaft ist die weit verbreitete Stigmatisierung der Erkrankung „Adipositas“ sowohl bei Betroffenen als auch bei therapeutischen Spezialisten eine wesentliche Ursache für diese Situation [ 5 , 9 , 10 ]. Große Bedeutung für die fehlende flächendeckende Verbreitung der Adipositaschirurgie hat aber ebenso die restriktive Politik hinsichtlich der Übernahme der Behandlungskosten durch die Kostenträger.…”

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Kostenübernahme bariatrischer Operationen ohne Antragstellung – Erfahrungen in einem deutschen Adipositaszentrum

et al. 2022

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Zusammenfassung Hintergrund Nur ein kleiner Teil der Patienten mit morbider Adipositas hat in Deutschland Zugang zur derzeit effektivsten Therapie, der bariatrischen Operation. Ein wesentlicher Grund ist die restriktive Haltung der Krankenkassen hinsichtlich der Kostenübernahme. Ziel der Arbeit Die Erfassung der postoperativen Rate an Kostenübernahmen durch die Krankenkassen ohne die derzeit übliche präoperative Antragstellung bei morbid adipösen Patienten, die eine leitliniengerecht indizierte bariatrische Operation in einem Adipositaszentrum in Bayern erhalten. Methodik Der Prozess der postoperativen Kostenübernahmen wurde durch eine prospektive Datenbank im Zeitraum von 2 Jahren evaluiert. Die Fälle primärer Kostenübernahme wurden hinsichtlich Alter, BMI, Komorbiditäten und der Mitgliedschaft in einer bestimmten Krankenkasse korreliert. Abgelehnte Kostenübernahmen wurden bezüglich des weiteren anwaltschaftlichen und sozialgerichtlichen Prozesses verfolgt. Ergebnisse Es wurden 188 Patienten ohne vorherige Antragstellung einer leitliniengerecht indizierten bariatrischen Operation zugeführt. Die primäre Kostenübernahme erfolgte in 76,6 % (n = 144). Es ergab sich keine Korrelation mit dem BMI, Komorbiditäten oder der Zugehörigkeit zu einer bestimmten Krankenkasse. Die Wahrscheinlichkeit einer postoperativen Kostenübernahme war bei Patienten über 40 Jahren signifikant wahrscheinlicher. Bei den Patienten ohne postoperative Kostenübernahme wurde in 7 Fällen eine außergerichtliche Einigung erreicht, 8 Fälle wurden rechtshängig, und 29 Fälle waren in anwaltschaftlicher Bearbeitung. Diskussion Trotz der relativ hohen Rate primärer Kostenübernahmen zeigt sich auch in dieser Analyse die restriktive Haltung der Krankenkassen bezüglich der bariatrischen Operation mit entsprechendem ökonomischem Druck auf die Leistungserbringer. Die konsequente Umsetzung des antragsfreien Operierens erscheint notwendig, um den politischen Druck auf die Krankenversicherungen und Sozialgerichte zu erhöhen.

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“…Stigmatization and discrimination of patients with overweight or obesity increased over the last decades in Western countries [1][2][3]. Weight bias toward patients with obesity is also common among healthcare professionals, including primary care physicians [4,5], and has even been reported in medical students [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

The Effect of a Multifaceted Intervention Including Classroom Education and Bariatric Weight Suit Use on Medical Students’ Attitudes toward Patients with Obesity

Renold¹,

Deferm²,

Hauser³

et al. 2023

Obes Facts

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Introduction Weight bias refers to negative attitudes towards individuals because of their weight. Evidenced-based strategies to successfully reduce weight bias in medical students are lacking. The purpose of this study was to investigate the impact of a multifaceted intervention on medical students’ attitudes towards patients with obesity. Methods Third- and fourth-year medical students (n= 79), who enrolled in an eight-week graduate course focusing on the various epidemiologic, physiological and clinical aspects of obesity, including a gamification task with bariatric weight suits (BWS), were asked to complete the Nutrition, Exercise and Weight Management (NEW) Attitudes Scale questionnaire pre- and post-course. The inclusion period was between 09/2018 and 06/2021 and covered 4 consecutive groups of students. Results The overall NEW Attitude Scale scores did not change significantly pre- versus post-intervention (pre-course: 19.59, post-course 24.21, p-value = 0.24). However, the subgroup of 4th year medical students showed a significant improvement of their attitudes (pre-course: 16.4, post-course 26.16, p-value = 0.02). The Thurstone rating of 9 out of 31 individual survey items changed significantly from pre- to post-course with a moderate strength (Cramer’s V > 0.2), including 5 items showing weight bias reduction. The disagreement with the statement “Overweight/obese individuals lack willpower” increased from 37 to 68%. Discussion/Conclusion These findings suggest that in medical students with a low level of weight bias at baseline, a semester course on obesity combined with BWS use affects only a limited number of items of the NEW Attitudes scale questionnaire. The sensitization of medical students to weight stigma has the potential to improve quality of healthcare for patients with obesity.

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Mindset and Communication Barriers in the Diffusion of Bariatric Surgery

Cited by 14 publications

References 57 publications

Online survey on factors influencing patients' motivation to undergo bariatric surgery

Online survey on factors influencing patients' motivation to undergo bariatric surgery

Kostenübernahme bariatrischer Operationen ohne Antragstellung – Erfahrungen in einem deutschen Adipositaszentrum

The Effect of a Multifaceted Intervention Including Classroom Education and Bariatric Weight Suit Use on Medical Students’ Attitudes toward Patients with Obesity

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