Teixeira M Elizabeth, Budd Geraldine M
Drexel University College of Nursing and Health Professions, Philadelphia, Pennsylvania 19102, USA.
J Am Acad Nurse Pract. 2010 Oct;22(10):527-33. doi: 10.1111/j.1745-7599.2010.00551.x. Epub 2010 Sep 3.
The purpose of this article is to increase awareness regarding the social problem of obesity stigma and its effects on persons with type 2 diabetes mellitus (T2DM). In addition, practical strategies to dispel stigma and improve diabetes care that nurse practitioners (NPs) can integrate into practice will be introduced.
Thorough review of the literature was conducted including MEDLINE, PsycINFO and CINAHL, spanning the years 1994-2008.
Obesity and diabetes are both epidemics that demand immediate attention; however, obesity stigma can act as a barrier to ongoing management of both conditions. Obese patients with T2DM may feel responsible not only for their weight but also their diabetes. Therefore, NPs can employ specific counseling strategies that may be beneficial with T2DM obese patients to improve continuity of care while decreasing weight-related stigmatization.
Negative attitudes toward obesity by healthcare professionals can act as a barrier to diabetes management. Primary care providers including NPs must begin through self-reflection to recognize their own attitudes regarding weight-stigma and how these attitudes may affect their patients. By implementing effective strategies to reduce weight bias, an environment conducive to diabetes and lifestyle modification management may prevent patients from forgoing care.
本文旨在提高对肥胖污名化这一社会问题及其对2型糖尿病（T2DM）患者影响的认识。此外，还将介绍执业护士（NPs）可纳入实践的消除污名化及改善糖尿病护理的实用策略。
对1994年至2008年期间的文献进行了全面回顾，包括MEDLINE、PsycINFO和CINAHL。
肥胖和糖尿病都是亟待关注的流行病；然而，肥胖污名化可能成为这两种疾病持续管理的障碍。患有T2DM的肥胖患者可能不仅觉得要为自己的体重负责，还要为自己的糖尿病负责。因此，NPs可以采用一些特定的咨询策略，这些策略可能对患有T2DM的肥胖患者有益，以改善护理的连续性，同时减少与体重相关的污名化。
医疗保健专业人员对肥胖的负面态度可能成为糖尿病管理的障碍。包括NPs在内的初级保健提供者必须首先通过自我反思来认识自己对体重污名化的态度，以及这些态度可能如何影响他们的患者。通过实施有效的策略来减少体重偏见，营造一个有利于糖尿病和生活方式改变管理的环境，可以防止患者放弃治疗。
