Jiwanmall Stephen A, Kattula Dheeraj, Nandyal Munaf B, Parvathareddy Sandhiya, Kirubakaran Richard, Jebasingh Felix, Paul Thomas V, Thomas Nihal, Kapoor Nitin
Psychiatry, Christian Medical College and Hospital, Vellore, IND.
Nutrition, Christian Medical College and Hospital, Vellore, IND.
Cureus. 2022 Jul 14;14(7):e26837. doi: 10.7759/cureus.26837. eCollection 2022 Jul.
Introduction Obesity being a global epidemic, currently has several adverse health outcomes. Weight stigma is a significant barrier to delivering quality services and also impairs clinical progress. We intended to study the association of stigma with demographic and clinical variables in obese patients to identify the obstacles in treatment-seeking, so stigma could be adequately addressed to improve clinical outcomes. Methods This study was a retrospective chart review in a Bariatric clinic in a tertiary care hospital. The weight self-stigma questionnaire (WSSQ) was routinely used in the clinic. Demographic and clinical data were collected for 146 obese patients. Results Female patients (73%) had higher stigma scores. The mean total stigma score was 41.6(SD 3.83), the total self-devaluation score was 21.88(SD 2.10), total fear of enacted stigma was 21.26(SD 2.33). Multivariate analysis revealed an association between stigma with multiple dysfunctional eating patterns like bingeing, overeating, and grazing (Adjusted aOR 3.86, 95% CI- 1.66-8.96) and psychiatric diagnosis (adjusted aOR 3.00, CI- 1.25-7.17). Conclusion This study found an association between stigma and certain clinical variables that maintain and worsen obesity and comorbid psychiatric diagnoses. This highlights the importance of an assessment of mental health and stigma in general practice when dealing with patients with obesity. Treating the underlying psychiatric comorbidities and addressing unhealthy eating behaviors can help reduce self-stigma. Stigma is a barrier to treatment-seeking that needs to be addressed in the community.
引言
肥胖作为一种全球流行病,目前会导致多种不良健康后果。体重歧视是提供优质服务的重大障碍,也会阻碍临床进展。我们旨在研究肥胖患者中歧视与人口统计学和临床变量之间的关联,以确定寻求治疗的障碍,从而能够充分应对歧视问题以改善临床结果。
方法
本研究是对一家三级护理医院的减肥诊所进行的回顾性病历审查。该诊所常规使用体重自我歧视问卷(WSSQ)。收集了146名肥胖患者的人口统计学和临床数据。
结果
女性患者(73%)的歧视得分更高。平均总歧视得分为41.6(标准差3.83),总自我贬低得分为21.88(标准差2.10),对实际发生的歧视的总恐惧得分为21.26(标准差2.33)。多变量分析显示,歧视与多种功能失调的饮食模式(如暴饮暴食、过度进食和随意进食)(调整后的优势比3.86,95%置信区间为1.66 - 8.96)以及精神疾病诊断(调整后的优势比3.00,置信区间为1.25 - 7.17)之间存在关联。
结论
本研究发现歧视与某些维持和加重肥胖及合并精神疾病诊断的临床变量之间存在关联。这凸显了在普通医疗实践中,在处理肥胖患者时评估心理健康和歧视的重要性。治疗潜在的精神疾病合并症并解决不健康的饮食行为有助于减少自我歧视。歧视是寻求治疗的障碍,需要在社区中加以解决。