Scots too scared of being stigmatised by medics to ask for obesity treatment

Published on Wednesday 27 May 2009 21:59

OBESE people in Scotland may avoid or delay asking for potentially life-saving treatment because they fear being judged and stigmatised by medical staff, a conference will hear today.

The meeting in Edinburgh will be told that almost 24,000 severely obese Scots would benefit from surgery to improve their health – but only 1 per cent of suitable patients are currently operated on, due to limited resources.

The Scottish Government maintained that surgery remained a "last resort" for obese patients and other measures were also being used.

The conference, organised by the Royal College of Physicians of Edinburgh and other medical colleges, will hear from experts concerned about the current treatment of obesity.

Previous research has suggested that "obesity bias" is common in health workers – even those specialising in treating overweight people.

Other studies have found that obese people may avoid or delay accessing important medical checks, such as cervical screening, because they fear being judged about their size.

Dr Pat Croskerry, professor of emergency medicine at Dalhousie University in Canada, said obesity bias was prevalent in society, including medicine.

"Obesity itself carries the risk of serious ill-health in a variety of disease areas and obesity bias can further result in compromised care for patients.

"If we wish to ensure obese patients receive the best quality of care, be it for a chronic obesity-related condition or in an emergency situation, and do not experience inequalities of treatment due to their size, medical staff need to avoid blaming or judging obese patients and concentrate on how to treat them."

The conference will also hear that although weight-loss surgery, such as fitting a gastric band, is generally seen as a last resort, there is increasing evidence it is clinically and cost effective.

The treatment can cause Type 2 diabetes to go into full remission in 90 per cent of severely obese patients.

Hypertension, heart disease and deaths from obesity-related cancers are also cut, saving money for the health service.

The newly formed Severe and Complex Obesity Treatment Service (Scots) now estimates that 24,000 severely obese people are both eligible and willing to have the surgery, but only 300 procedures are carried out each year – only half of them on the NHS.

Duff Bruce, a bariatric surgeon and chairman of Scots, said: "We believe it is now time to significantly expand the provision of bariatric surgery throughout Scotland and to ensure that severely obese patients throughout Scotland can obtain equitable access to this treatment regardless of where they live."

The conference will also hear from public health minister Shona Robison, setting out new measures to tackle obesity.

A Scottish Government spokeswoman said: "There is a place for bariatric surgery in Scotland but it is a last resort.

"The key is to prevent obesity in the first place and we have a number of measures in place to try to do that, as well as working to help people reach a healthy weight."