Analyzing the approach and treatment applied by Endocrinology- and Metabology-expert physicians to patients living with excess weight
Medical approach to excess weight
DOI:
https://doi.org/10.34019/1982-8047.2022.v48.36234Keywords:
Obesity, Endocrinology, Social Stigma, Physician-Patient Relationship, Practice Guidelines as TopicAbstract
Introduction: Body weight increase is a contemporary trend that leads to health issues in the world’s population. Social stigma associated with this patient profile has negative repercussions, mainly in physician-patient interactions, which can result in weight gain and in increased mortality rates. Thus, the management of this worldwide disease requires a better understanding of its multiple aspects, as recommended by international guidelines. Purpose: The aim of the current study was to analyze some aspects of the therapeutic approach adopted by Endocrinology and Metabology-expert physicians to treat patients living with excess weight, based on information available in current guidelines. Methodology: Observational, cross-sectional study conducted with convenience sample deriving from the scientific update group “EndoNews”, which is hosted in online platform. Data were collected through structured questionnaire completed by 246 participants. Similar responses were grouped and subjected to Chi-square tests, at 5% Alpha. Results: 72% of physicians reported to have additional difficulties to treat this patient profile (PWD). PWD reports were mostly associated with work environments described as ill-equipped (p-value = 0.009), with the Northern and Northeastern macroregions (p-Value = 0.012), with weak belief in long-term therapeutic success (p-value = 0.004) and with approach self-reported as less encouraging (p-value = 0.001). Other variables presenting statistical significance were also reported. Conclusion: It was possible drawing different profiles for physicians with (PWD) and without difficulty (PND) to treat patients living with excess weight. Factors, such as region of practice and ill-equipped infrastructure, were predictive of such a difficulty. Moreover, certain factors used to analyze participants’ agreement with guidelines have shown that PWD diverged more often from the recommended information. Therefore, reflections on language, strategies and infrastructural preparedness to serve these patients were suggested, aiming at subsequent changes in physicians’ attitude towards their treatment.
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References
World Health Organization. Obesity: preventing and managing the global epidemic: report of a WHO consultation [Internet]. Geneva: World Health Organization; 1999 [cited 2020 July 13]. Available at: https://apps.who.int/iris/handle/10665/42330
World Health Organization. Obesity and overweight [Internet]. 2017 [cited 2020 July 15]. Available at: https://www.who.int/newsroom/fact-sheets/detail/obesity-and-overweight.
GBD 2017 Causes of Death Collaborators. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018; 392(10159):1736-88. doi: 10.1016/S0140-6736(18)32203-7.
Pan American Health Organization. Obesity prevention [Internet]. 2017 [cited 2020 July 20]. Available at: https://www.paho.org/hq/index.php?option=com_content&view=ar ticle&id=11506:obesity-prevention-home&Itemid=41655&lang=en.
Ministério da Saúde (BR). Secretaria de Vigilância em Saúde. Departamento de Análise em Saúde e Vigilância de Doenças Não Transmissíveis. Vigitel Brasil 2018: vigilância de fatores de risco e proteção para doenças crônicas por inquérito telefônico. Brasília: Ministério da Saúde; 2019 [cited 2020 July 24]. Available at: https://abeso.org.br/wp-content/uploads/2020/01/vigitel-brasil-2018.pdf
Danaei G, Finucane MM, Lu Y, Singh GM, Cowan MJ, Paciorek CJ et al. global burden of metabolic risk factors of chronic diseases collaborating group (blood glucose): national, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2.7 million participants. Lancet. 2011; 378(9785):31-40. doi: 10.1016/S0140-6736(11)60679-X.
Bahia L, Coutinho ES, Barufaldi LA, Abreu Gde A, Malhão TA, Souza CP et al. The costs of overweight and obesity-related diseases in the Brazilian public health system: cross-sectional study. BMC Public Health. 2012; 12:440. doi: 10.1186/1471-2458-12-440.
Silva Junior GB, Bentes AC, Daher EF, Matos SM. Obesity and kidney disease. J Bras Nefrol. 2017; 39(1):65-9. doi: 10.5935/0101-2800.20170011.
Calle EE, Thun MJ. Obesity and cancer. Oncogene. 2004; 23(38):6365-78. doi: 10.1038/sj.onc.1207751.
Horton R. Offline: COVID-19 is not a pandemic. Lancet. 2020; 396(10255):874. doi: 10.1016/S0140-6736(20)32000-6.
Swinburn B, Egger G, Raza F. Dissecting obesogenic environments: the development and application of a framework for identifying and prioritizing environmental interventions for obesity. Prev Med. 1999; 29(6 Pt 1):563-70. doi: 10.1006/pmed.1999.0585.
Swinburn B, Kraak V, Rutter H, Vandevijvere S, Lobstein T, Sacks G et al. Strengthening of accountability systems to create healthy food environments and reduce global obesity. Lancet. 2015; 385(9986):2534-45. doi: 10.1016/S0140-6736(14)61747-5.
Butland B, Jebb SA, Kopelman P et al. Foresight ‘tackling obesities: future choices’ project. 2. ed. Government Office for Science. 2007 [cited 2020 July 20]. Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/287937/07-1184x-tackling-obesities-future-choices-report.pdf
Albury C, Strain WD, Brocq SL, Logue J, Lloyd C, Tahrani A. Language matters working group: the importance of language in engagement between health-care professionals and people living with obesity: a joint consensus statement. Lancet Diabetes Endocrinol. 2020; 8(5):447-55. doi: 10.1016/S2213-8587(20)30102-9.
Gray CM, Hunt K, Lorimer K, Anderson AS, Benzeval M, Wyke S. Words matter: a qualitative investigation of which weight status terms are acceptable and motivate weight loss when used by health professionals. BMC Public Health. 2011; 11:513. doi: 10.1186/1471-2458-11-513.
Associação Brasileira para o Estudo da Obesidade e da Síndrome Metabólica (BR). Diretrizes brasileiras de obesidade. 4. ed. São Paulo: ABESO; 2016.
Rubino F, Puhl RM, Cummings DE, Eckel RH, Ryan DH, Mechanick JI et al. Joint international consensus statement for ending stigma of obesity. Nat Med. 2020; 26(4):485-97. doi: 10.1038/s41591-020-0803-x.
Scheffer M (coord.). Demografia médica no Brasil: 2020. São Paulo: FMUSP, CFM; 2020. ISBN: 978-65-00-12370-8
Uchimura LYT, Felisberto E, Fusaro ER, Ferreira MP, Viana ALA. Evaluation performance in health regions in Brazil. Rev Bras Saúde Mater Infant. 2017; 17(Supl.1):S253-S27010. doi: 1590/1806-9304201700S100012.
Martin LR, Williams SL, Haskard KB, Dimatteo MR. The challenge of patient adherence. Ther Clin Risk Manag. 2005; 1(3):189-99
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Copyright (c) 2022 José Victor Fecuri Lopardi, Samuel, Lucas, Danielle, Fernando, Lize , Alberto, Christianne
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