Hansson Lena M, Rasmussen Finn
Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.
Obes Facts. 2014;7(3):211-20. doi: 10.1159/000363557. Epub 2014 Jun 4.
BACKGROUND/AIMS: This study examined the association between experiences of health care stigmatization and BMI changes in men and women with normal weight and obesity in Sweden.
The participants were drawn from a population-based survey in Sweden (1996-2006), and data on their perceived health care stigmatization were measured in 2008. They were categorized in individuals with normal weight (n = 1,064), moderate obesity (n = 1,273), and severe obesity (n = 291). The main outcome measure was change in BMI.
Individuals with severe obesity experiencing any health care stigmatization showed a BMI increase by 1.5 kg/m2 more than individuals with severe obesity with no such experience. For individuals with moderate obesity, insulting treatment by a physician and avoidance of health care were associated with a relative BMI increase of 0.40 and 0.75 kg/m2, respectively, compared with their counterparts who did not experience stigmatization in these areas. No difference in experience of any form of health care stigmatizing associated BMI change was observed for men and women with normal weight.
In this large, population-based study, perceived health care stigmatization was associated with an increased relative BMI in individuals with severe obesity. For moderate obesity, the evidence of an association was inconclusive.
背景/目的:本研究调查了瑞典体重正常及肥胖的男性和女性中,医疗污名化经历与体重指数(BMI)变化之间的关联。
参与者来自瑞典一项基于人群的调查(1996 - 2006年),2008年测量了他们感知到的医疗污名化数据。他们被分为体重正常者(n = 1064)、中度肥胖者(n = 1273)和重度肥胖者(n = 291)。主要结局指标是BMI的变化。
经历过任何医疗污名化的重度肥胖者的BMI比未经历过此类情况的重度肥胖者高出1.5 kg/m²。对于中度肥胖者,与在这些方面未经历污名化的同行相比,医生的侮辱性治疗和回避医疗分别与BMI相对增加0.40和0.75 kg/m²相关。体重正常的男性和女性在任何形式的医疗污名化相关的BMI变化经历方面未观察到差异。
在这项基于人群的大型研究中,感知到的医疗污名化与重度肥胖个体的相对BMI增加有关。对于中度肥胖,关联证据尚无定论。