Sex, Race, and the Adverse Effects of Social Stigma vs. Other Quality of Life Factors Among Primary Care Patients with Moderate to Severe Obesity

Wee, Christina C.; Davis, Roger B.; Chiodi, Sarah; Huskey, Karen W.; Hamel, Mary Beth

doi:10.1007/s11606-014-3041-4

Cited by 35 publications

(46 citation statements)

References 18 publications

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“…30,32 In a telephone survey of 325 severely obese patients seen at four primary care practices in the Boston area, Wee and colleagues found that African American and Hispanic ethnicities were more likely to consider undergoing bariatric surgery if they received a physician recommendation for surgery but were less likely to consider it if they were older. 37 …”

Section: Resultsmentioning

confidence: 99%

Patient and Referring Practitioner Characteristics Associated With the Likelihood of Undergoing Bariatric Surgery

et al. 2015

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Importance Although bariatric surgery is the most cost-effective treatment for severe obesity, less than 1% of severely obese patients undergo it. Reasons for low utilization are unclear. Objectives To identify patient and referring provider characteristics associated with the likelihood of undergoing bariatric surgery. Evidence Review PubMed, PsycINFO, CINAHL, and the Cochrane databases were searched for reports published between January 1, 1998, and December 31, 2014. Reports were eligible if they presented descriptive data regarding facilitators or barriers to bariatric surgery or if they reported statistical associations between patient or provider characteristics and referral to or receipt of bariatric surgery. Frequency effect sizes were calculated as the proportion of studies reporting a finding. Findings Of the 7,212 reports identified in the initial search, 53 were included in full-text review. Nine reports met our inclusion criteria and were included in analyses. Of those, four included descriptive findings, six reported statistical associations, and one included both. One report included providers as study participants, whereas eight included patients. Four of nine studies identified an association between female gender and a greater willingness to undergo bariatric surgery. Lack of knowledge about bariatric surgery was a barrier in two studies. Five of nine cited patient concerns about the outcomes and safety of bariatric surgery as a barrier to undergoing it. Patients were more likely to pursue bariatric surgery when it was recommended by referring providers. Providers who believed that obesity treatment should be covered by insurance were more likely to recommend bariatric surgery. Conclusions and Relevance Limited patient and referring provider knowledge about the safety and effectiveness of bariatric surgery are important barriers to bariatric surgery utilization. Future efforts focused on improving knowledge and identification of the critical determinants of obesity treatment decision making from both the provider and patient perspectives would have an important public heath impact.

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Section: Resultsmentioning

confidence: 99%

Patient and Referring Practitioner Characteristics Associated With the Likelihood of Undergoing Bariatric Surgery

et al. 2015

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“…Rather, it focused on barriers to referral faced by primary care physicians (PCPs) [13]. Another study included in the systematic review found that PCP recommendations were identified as an important predictor of whether a patient would consider bariatric surgery [12,14].…”

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Primary care physician decision making regarding severe obesity treatment and bariatric surgery: a qualitative study

Funk

Jolles

Greenberg

et al. 2016

Surgery for Obesity and Related Diseases

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Background: Less than 1% of severely obese US adults undergo bariatric surgery annually. It is critical to understand the factors that contribute to its utilization. Objectives: To understand how primary care physicians (PCPs) make decisions regarding severe obesity treatment and bariatric surgery referral. Setting: Focus groups with PCPs practicing in small, medium, and large cities in Wisconsin. Methods: PCPs were asked to discuss prioritization of treatment for a severely obese patient with multiple co-morbidities and considerations regarding bariatric surgery referral. Focus group sessions were analyzed by using a directed approach to content analysis. A taxonomy of consensus codes was developed. Code summaries were created and representative quotes identified.Results: Sixteen PCPs participated in 3 focus groups. Four treatment prioritization approaches were identified: (1) treat the disease that is easiest to address; (2) treat the disease that is perceived as the most dangerous; (3) let the patient set the agenda; and (4) address obesity first because it is the common denominator underlying other co-morbid conditions. Only the latter approach placed emphasis on obesity treatment. Five factors made PCPs hesitate to refer patients for bariatric surgery: (1) wanting to "do no harm"; (2) questioning the long-term effectiveness of bariatric surgery; (3) limited knowledge about bariatric surgery; (4) not wanting to recommend bariatric surgery too early; and (5)

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“…Los estudios son consistentes en demostrar que la estigmatización ocurre hacia hombres y mujeres por igual, no obstante, cuando las víc-timas de esta estigmatización son mujeres, ellas refieren peor calidad de vida y bienestar, además de autoestima reducida en comparación a los hombres, quienes reportan problemas asociados al ámbito laboral 6,7 , es decir, las mujeres podrían verse mayormente afectadas cuando son víctimas de este estigma 8 .…”

Section: Contextualización General Del Estigma De Obesidadunclassified

Estigma de obesidad, su impacto en las víctimas y en los Equipos de Salud: una revisión de la literatura

2017

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Sex, Race, and the Adverse Effects of Social Stigma vs. Other Quality of Life Factors Among Primary Care Patients with Moderate to Severe Obesity

Cited by 35 publications

References 18 publications

Patient and Referring Practitioner Characteristics Associated With the Likelihood of Undergoing Bariatric Surgery

Patient and Referring Practitioner Characteristics Associated With the Likelihood of Undergoing Bariatric Surgery

Primary care physician decision making regarding severe obesity treatment and bariatric surgery: a qualitative study

Estigma de obesidad, su impacto en las víctimas y en los Equipos de Salud: una revisión de la literatura

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