Jackson Leach Rachel, Powis Jaynaide, Baur Louise A, Caterson Ian D, Dietz William, Logue Jennifer, Lobstein Tim
World Obesity Federation, London, UK.
Discipline of Child and Adolescent Health, University of Sydney, New South Wales, Australia.
Clin Obes. 2020 Apr;10(2):e12357. doi: 10.1111/cob.12357. Epub 2020 Mar 3.
Obesity is a chronic relapsing condition affecting a rapidly increasing number of people worldwide. The United Nations has stated that universal health coverage is an essential element of the globally-agreed sustainable development goals. This article provides a preliminary report of a survey of relevant health professionals and other interest groups on the readiness of health systems to provide obesity treatment services. Interviews and questionnaires were completed by 274 respondents from a total of 68 low, middle and high income countries. Respondents in the majority of countries stated that there were professional guidelines for obesity treatment, but that there was a lack of adequate services, especially in lower income countries, and in rural areas of most countries. Lack of treatment was attributed to a broad range of issues including: no clear care pathways from primary care to secondary services; absent or limited secondary services in some regions; lack of trained multi-disciplinary support professionals; potentially high costs to patients; long waiting times for surgery; and stigma experienced by patients within the health care services. Defining obesity as a disease may help to overcome stigma and may also help to secure better funding streams for treatment services. However, the survey found that few countries were ready to accept this definition. Furthermore, until countries fully adopt and implement obesity prevention policies the need for treatment will continue to rise while the necessary conditions for treatment will remain inadequate.
肥胖是一种慢性复发性疾病，全球受其影响的人数正在迅速增加。联合国指出，全民健康覆盖是全球商定的可持续发展目标的一个基本要素。本文提供了一份对相关卫生专业人员和其他利益集团的调查初步报告，内容涉及卫生系统提供肥胖治疗服务的准备情况。来自68个低收入、中等收入和高收入国家的274名受访者完成了访谈和问卷调查。大多数国家的受访者表示，存在肥胖治疗的专业指南，但缺乏足够的服务，尤其是在低收入国家以及大多数国家的农村地区。治疗缺乏归因于一系列广泛的问题，包括：从初级保健到二级服务没有明确的护理途径；一些地区二级服务缺失或有限；缺乏训练有素的多学科支持专业人员；患者可能面临高昂费用；手术等待时间长；以及患者在医疗服务中遭受耻辱感。将肥胖定义为一种疾病可能有助于克服耻辱感，也可能有助于为治疗服务争取更好的资金流。然而，调查发现很少有国家准备接受这一定义。此外，在各国全面采纳并实施肥胖预防政策之前，治疗需求将继续上升，而治疗所需的必要条件仍将不足。
