The effect of obesity on medical students’ approach to patients with abdominal pain

Wigton, Robert S.; McGaghie, William C.

doi:10.1046/j.1525-1497.2001.016004262.x

Cited by 81 publications

(66 citation statements)

References 12 publications

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“…Negative attitudes by health care providers have been documented. [19][20][21][22][23] The results presented here show that women are well aware of negative attitudes and are reluctant to have medical appointments with such providers. An important issue concerns whether it is desirable to give obese women unsolicited weight-loss advice.…”

Section: Discussionmentioning

confidence: 99%

Barriers to routine gynecological cancer screening for White and African-American obese women

Amy

Aalborg

Lyons³

et al. 2005

Int J Obes

340

333

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Background: Obese women are reported to be at higher risk from gynecological cancers than nonobese women, yet these women are less likely to get cancer-screening tests. The specific factors that contribute to obese women not obtaining timely cancer screening have not been identified. Objective: To investigate the factors that contribute to lower rates of gynecological cancer screening as related to women's body size. Design: A purposeful sample of 498 White and African-American women with body mass index (BMI) from 25 to 122 kg/m 2 , including 60 women with BMI455 kg/m 2 , was surveyed concerning access to gynecological cancer screening and potential barriers that could cause delay. Health care providers (N ¼ 129) were surveyed concerning their education, practices, and attitudes about providing care and gynecological cancer-screening tests for obese women. Results: Obese women reported that they delay cancer-screening tests and perceive that their weight is a barrier to obtaining appropriate health care. The percent of women reporting these statements increased significantly as the women's BMI increased. Women with BMI455 kg/m 2 had a significantly lower rate (68%) of Papanicolaou (Pap) tests compared to others (86%). The lower screening rate was not a result of lack of available health care since more than 90% of the women had health insurance. Women report that barriers related to their weight contribute to delay of health care. These barriers include disrespectful treatment, embarrassment at being weighed, negative attitudes of providers, unsolicited advice to lose weight, and medical equipment that was too small to be functional. The percentage of women who reported these barriers increased as the women's BMI increased. Women who delay were significantly less likely to have timely pelvic examinations, Pap tests, and mammograms than the comparison group, even though they reported that they were 'moderately' or 'very concerned' about cancer symptoms. The women who delay care were also more likely to have been on weight-loss programs five or more times. Many health care providers reported that they had little specific education concerning care of obese women, found that examining and providing care for large patients was more difficult than for other patients, and were not satisfied with the resources and referrals available to provide care for them. Conclusion: Since the goal of preventive cancer screening is to improve health outcomes for all women and since obese women are at greater risk, strategies must be designed to reduce the weight barriers to these tests and improve the quality of the health care experience. Providers should receive specific training related to care of large women.

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Section: Discussionmentioning

confidence: 99%

Barriers to routine gynecological cancer screening for White and African-American obese women

Amy

Aalborg

Lyons³

et al. 2005

Int J Obes

340

333

View full text Add to dashboard Cite

show abstract

“…Overweight adults report feeling stigmatized, stereotyped [6], and treated disrespectfully [7] within their communities and by medical professionals. Health care providers, nurses, and medical students have been reported to perceive obese adult patients as lazy and lacking selfcontrol [8,9] and to believe they are less likely to comply with prescribed treatment regimens than patients of normal weight [10,11]. Based upon these findings, it is perhaps not surprising that many overweight adults report that physicians do not understand the extent to which overweight causes difficulty in their lives [12].…”

Section: Methods-thementioning

confidence: 99%

Weight and its relationship to adolescent perceptions of their providers (WRAP): A qualitative and quantitative assessment of teen weight-related preferences and concerns

Cohen

Tanofsky‐Kraff

Young-Hyman

et al. 2005

Journal of Adolescent Health

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Purpose-To examine the relationship of body weight to satisfaction with care in adolescents, and to obtain qualitative data on preferences for general and weight-related medical care in normal weight and overweight adolescents. Methods-TheWeight and its Relationship to Adolescent Perceptions of their Providers survey, a 4-page questionnaire containing previously validated satisfaction scales and open-ended qualitative questions regarding health care preferences, was administered to 62 severely overweight (body mass index [BMI] 38.9 ± 8.4 kg/m 2 ) and 29 normal weight (BMI 22.5 ± 4.0 kg/m 2 ) adolescents (age 13.9 ± 1.7 years; 57% female; 50% Caucasian, 47% African-American, 3% Hispanic).Results-The affective subscale of the medical satisfaction scale was negatively correlated with BMI standard deviation score (r = −.22, p < .05). Multiple regression models predicting affective satisfaction with medical care included BMI standard deviation score; however, continuity with provider appeared to be the strongest independent predictor of affective satisfaction. Fifty-five percent of participants identified their mother as the person they felt most comfortable talking with about weight, although 68% believed their provider knew the most about healthy eating. "Overweight" was identified by 47% of participants as the preferred term for heavy teens. Seventynine percent of overweight adolescents stated their health care provider discussed their weight with them; however, only 41% of overweight adolescents desired to discuss their weight. Compared to normal-weight adolescents, overweight teens were more likely to report that their provider raised topics of weight (p < .001), diet (p < .01), and exercise (p < .01) at their last physical, and were more likely to report that they would have liked their provider to discuss diet and exercise (both p < .05). Ten percent of overweight teens expressed concerns regarding the public location of their provider's office scale.Conclusions-Satisfaction with affective aspects of the provider-patient relationship is negatively correlated with BMI standard deviation score. Length of experience with one's provider is also a strong predictor of teen satisfaction with their medical care. Teens prefer the term "overweight" for those with high body weight. Sensitivity to confidentiality, privacy, and embarrassment regarding physical examination and weight are important for teen satisfaction. Overweight adults report feeling stigmatized, stereotyped [6], and treated disrespectfully [7] within their communities and by medical professionals. Health care providers, nurses, and medical students have been reported to perceive obese adult patients as lazy and lacking selfcontrol [8,9] and to believe they are less likely to comply with prescribed treatment regimens than patients of normal weight [10,11]. Based upon these findings, it is perhaps not surprising that many overweight adults report that physicians do not understand the extent to which overweight causes difficulty in their lives [12]...

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“…Muitas pessoas obesas relatam ter sofrido tratamento negativo por parte de vários profissionais, como, por exemplo: nutricionistas (OBERRIEDER et al, 1995), estudantes de medicina (WIGTON;MCGAGHIE, 2001), médicos (HEBL; XU, 2001), enfermeiros (MARONEY; GOLUB, 1992) e outros especialistas em obesidade (SCHWARTZ et al, 2003;BROWNELL, 2001). A discriminação das pessoas obesas já é difundida em vários contextos de vida, inclusive no ambiente de trabalho (ROTHBLUM; MILLER; GARBUTT, 1988), no qual existe uma disparidade nas perspectivas de carreira e na obtenção de promoções (PAGAN; DAVILA, 1997), e no contexto escolar, no qual emergem comportamentos de rejeição e marginalização (CRANDALL, 1991;NEUMARK-SZTAINER;STORY;FAIBISCH, 1998).…”

Section: Introductionunclassified

Um Estudo Exploratório Da Tendência “Antiobesidade” Entre Professores E Estudantes De Educação Física Italianos

et al. 2017

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Resumo: O objetivo desta pesquisa foi analisar as atitudes implícitas e explícitas sobre a obesidade em professores e estudantes de Educação Física. Dezoito professores e 45 estudantes preencheram quatro questionários: o Teste de Associação Implícita (IAT), que avalia por meio de categorizações os estereótipos e as associações cognitivas espontâneas; o questionário de Crandall para a avaliação do preconceito explícito sobre a obesidade; a Escala sobre a Orientação à Dominância Social (SDO); e o Questionário de Autodescrição Física -versão curta (PSDQ-s). Ambos os grupos reportaram preconceito significativo (p < 0,05), evidenciado pelos valores médios registrados pelo IAT. Os professores relataram valores significativamente maiores no preconceito implícito e valores mais baixos na SDO comparados aos estudantes. A Orientação à Dominância Social mostrou-se uma variável chave na presença do preconceito. Este estudo pode ser um ponto de partida para futuras pesquisas focadas na redução do preconceito por meio de protocolos de intervenção específicos.Abstract: This study looked into Physical Education teachers' and students' implicit and explicit attitudes toward obesity. Eighteen teachers and 45 students completed four questionnaires: the Implicit Association Test (IAT), which assesses stereotypes and spontaneous cognitive associations through categorizations; The Crandall questionnaire for the evaluation of explicit prejudice about obesity; The Social Dominance Orientation Scale (SDO); and the Physical Self-Description Questionnaire -short version (PSDQ-s). Both groups reported significant prejudice (p <0.05), evidenced by the mean values recorded on the IAT. Teachers reported significantly higher values than students on implicit prejudice and lower values on SDO. Social Dominance Orientation proved to be a key variable in the presence of prejudice. This study may be a starting point for future research focused on reducing prejudice through specific intervention protocols.Resumen: El objetivo de este estudio fue analizar las actitudes implícitas y explícitas sobre la obesidad entre profesores y estudiantes de educación física. Dieciocho profesores y 45 estudiantes completaron cuatro cuestionarios: el Test de Asociación Implícita (IAT), que evalúa estereotipos y asociaciones cognitivas espontáneas; el cuestionario de Crandall para evaluar el prejuicio explícito acerca de la obesidad; la Escala de Orientación a la Dominancia Social (SDO); y el Cuestionario de Autoconcepto Físico -versión corta (PSDQ-s). Ambos grupos reportaron perjuicio significativo (p <0,05), como se evidencia por los valores medios registrados por el IAT. Los profesores reportaron valores significativamente más altos en el prejuicio implícito y valores más bajos en la SDO en comparación con los estudiantes. La Orientación a la Dominancia Social demostró ser una variable clave en la presencia de perjuicios. Este estudio puede ser un punto de partida para futuras investigaciones enfocadas en la reducción del perjuicio a través de protocolos de interv...

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The effect of obesity on medical students’ approach to patients with abdominal pain

Cited by 81 publications

References 12 publications

Barriers to routine gynecological cancer screening for White and African-American obese women

Barriers to routine gynecological cancer screening for White and African-American obese women

Weight and its relationship to adolescent perceptions of their providers (WRAP): A qualitative and quantitative assessment of teen weight-related preferences and concerns

Um Estudo Exploratório Da Tendência “Antiobesidade” Entre Professores E Estudantes De Educação Física Italianos

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