Department of Obstetrics and Gynecology, Carmel Medical Center, Genetics Institute, 7 Michal St, Haifa, Israel.
The Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel.
Isr J Health Policy Res. 2022 Jan 31;11(1):5. doi: 10.1186/s13584-022-00518-9.
Weight stigmatization, a common phenomenon in the healthcare system, exerts numerous adverse consequences on patients' wellbeing. The objective of this study was to estimate the extent and characteristics of weight stigmatization in Israel, based on the reports of overweight and obese individuals.
This study was performed by distribution of a cross-sectional open anonymous survey in social media platforms, targeting respondents with body mass index over 25 kg/m. The questionnaire consisted of Likert-scale based as well as open-ended questions, evaluating the experience during past medical appointments. Our primary outcome was the prevalence of disrespectful treatment. Subgroup analysis was performed by various demographic characteristics.
Of the 1697 respondents, 59.0% reported frequent experiences of disrespectful approach, and 48.6% noted receiving suboptimal treatment related to excess weight. Insulting, insensitive and judgmental comments were noted by 58%, stemming from diverse healthcare disciplines, while 29.3% noted office equipment not suitable for overweight people. Avoidance of a needed medical appointment was reported by 40.5%, significantly associated with past adverse experiences of weight stigmatization in the healthcare system. The respondents offered numerous suggestions to improve the existing situation, including education of the medical personnel, thorough research of obesity, and establishment of specific guidelines for approach to patients with excess weight.
Weight stigmatization is prevalent in Israeli healthcare system; thus, decreasing the rates of this phenomenon should be an important national goal. Formal education about the wide prevalence and adverse effects of weight stigmatization should be practiced by academic institutions, professional organizations, and regulatory bodies. Straightforward policies with continuing supervision should be endorsed by the healthcare system to prevent weight-based discrimination. Finally, appropriate-size equipment for obese patients should become one of the requirements for accreditation of medical centers and facilities.
体重歧视是医疗体系中常见的现象，它会给患者的健康带来诸多负面影响。本研究旨在根据超重和肥胖个体的报告，评估以色列体重歧视的程度和特征。
本研究通过在社交媒体平台上分发横断面开放式匿名调查，针对 BMI 超过 25kg/m2 的受访者进行。问卷包括基于李克特量表的问题和开放式问题，评估过去医疗预约期间的经历。我们的主要结局是不尊重治疗的发生率。通过各种人口统计学特征进行亚组分析。
在 1697 名受访者中，59.0%报告经常经历不尊重的态度，48.6%注意到与超重相关的治疗效果不佳。58%的人注意到来自不同医疗学科的侮辱性、麻木不仁的和评判性的评论，而 29.3%的人注意到不适合超重人士的办公设备。40.5%的人回避了必要的医疗预约，这与他们在医疗体系中经历过的体重歧视的不良经历显著相关。受访者提出了许多改善现状的建议，包括对医务人员进行教育、对肥胖进行深入研究，以及为超重患者制定具体的处理指南。
体重歧视在以色列医疗体系中很普遍；因此，降低这种现象的发生率应该是一个重要的国家目标。学术机构、专业组织和监管机构应开展关于体重歧视广泛流行和不良影响的正规教育。医疗体系应支持制定明确的政策并持续监督，以防止基于体重的歧视。最后，为肥胖患者提供合适尺寸的设备应成为医疗中心和设施认证的要求之一。
