Steno Diabetes Center Copenhagen, University of Copenhagen, Gentofte, Denmark.
Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
Diabetes Obes Metab. 2023 Sep;25(9):2595-2604. doi: 10.1111/dom.15144. Epub 2023 Jun 5.
Weight bias, stigma and discrimination are pervasive in the health care system and society and may result in biased treatment of people living with obesity (PwO). We aimed to identify perceptions, attitudes and potential barriers that exist between people with obesity and health care professionals (HCPs) in Denmark.
The ACTION-DK survey was a cross-sectional, non-interventional, descriptive study conducted in Denmark. The cohort included 879 PwO (body mass index ≥30.0 kg/m ) based on self-reported height and body weight, and 100 HCPs from the primary and secondary sectors who frequently encountered PwO.
Several discrepancies between PwO and HCPs were identified, including recognition of obesity as a chronic disease (PwO: 49% vs. HCPs: 84%) and whether PwO were responsible for their weight loss (PwO: 81% vs. HCPs: 17%). Among PwO, 46% were motivated to lose weight, but only 28% of HCPs shared this perception. Untimely initiation of obesity care consultations was also identified as a potential barrier to proper obesity care, as PwO waited 7 years, on average, from their initial decision to lose weight before having their first obesity care consultation. In addition, only 24% of PwO had a follow-up consultation after the initial obesity care discussion. Almost half of HCPs (46%) considered weight loss medication effective, but only 10% brought up this possibility during an obesity care discussion.
Our findings suggest that it is pivotal to improve obesity care in Denmark by ensuring a better follow-up and alignment of the perceptions and attitudes toward obesity between PwO and HCPs.
在医疗保健系统和社会中,体重偏见、耻辱和歧视普遍存在,可能导致肥胖患者(PwO)受到有偏见的待遇。我们旨在确定丹麦肥胖患者和医疗保健专业人员(HCPs)之间存在的看法、态度和潜在障碍。
ACTION-DK 调查是一项在丹麦进行的横断面、非干预性、描述性研究。该队列包括 879 名 PwO(BMI≥30.0kg/m ),基于自我报告的身高和体重,以及 100 名来自初级和二级卫生保健部门的经常接触 PwO 的 HCPs。
确定了 PwO 和 HCPs 之间的几个差异,包括肥胖被视为慢性病的认知(PwO:49%vs.HCPs:84%)和 PwO 是否对体重减轻负责(PwO:81%vs.HCPs:17%)。在 PwO 中,有 46%有减肥的动机,但只有 28%的 HCPs 有同样的看法。肥胖护理咨询的时机不当也被认为是肥胖护理不当的一个潜在障碍,因为 PwO 在最初决定减肥后平均要等待 7 年才开始第一次肥胖护理咨询。此外,只有 24%的 PwO 在最初的肥胖护理讨论后进行了随访咨询。近一半的 HCPs(46%)认为减肥药物有效,但只有 10%的人在肥胖护理讨论中提出了这种可能性。
我们的研究结果表明,通过确保更好地跟进和调整 PwO 和 HCPs 对肥胖的看法和态度,改善丹麦的肥胖护理至关重要。