Dataset Information

Language Matters: Patients' Preferred Terms for Discussing Obesity and Disordered Eating with Health Care Providers After Bariatric Surgery.

ABSTRACT:

Objective

Patients who seek or undergo bariatric surgery are likely to experience pervasive societal biases regarding weight and eating behaviors in the health care system. This cross-sectional study examined patient preferences for desired weight- and eating-related terms for health care providers among individuals with loss-of-control eating after bariatric surgery.

Methods

A total of 114 of 140 adults who underwent bariatric surgery approximately 1.5 years prior and were in the follow-up stage of a controlled treatment trial testing behavioral treatments completed language preference measures.

Results

Of the 11 terms used to describe weight, only 2 were viewed neutrally, weight and BMI. All other terms, including obesity, were rated negatively, and many were rated extremely negatively. Fatness was the least desirable term. Of the 18 terms used to describe loss-of-control eating, one ("ate until uncomfortably full") was rated positively, and several were rated neutrally. On average, none of the weight or loss-of-control eating terms was rated as "desirable" or "very desirable." Analyses revealed few gender and racial differences in language preferences.

Conclusions

Many weight-related and loss-of-control eating terms are viewed as undesirable. Health care providers should begin with neutrally rated terms and ask patients about their language preferences when speaking with individuals before/after bariatric surgery to improve patient-centered care and reduce perceived weight bias.

SUBMITTER: Ivezaj V

PROVIDER: S-EPMC7501175 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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Publications

Language Matters: Patients' Preferred Terms for Discussing Obesity and Disordered Eating with Health Care Providers After Bariatric Surgery.

Ivezaj Valentina V Lydecker Janet A JA Grilo Carlos M CM

Obesity (Silver Spring, Md.) 20200713 8

<h4>Objective</h4>Patients who seek or undergo bariatric surgery are likely to experience pervasive societal biases regarding weight and eating behaviors in the health care system. This cross-sectional study examined patient preferences for desired weight- and eating-related terms for health care providers among individuals with loss-of-control eating after bariatric surgery.<h4>Methods</h4>A total of 114 of 140 adults who underwent bariatric surgery approximately 1.5 years prior and were in the ...[more]

PMID: 32662251

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Project description:BackgroundThere is a significant burden of sleep disordered breathing (SDB) in patients living with severe and complex obesity undergoing pre-bariatric surgery assessment. This longitudinal observational study evaluated the burden of obesity hypoventilation syndrome (OHS) in this cohort of patients and the therapeutic compliance of patients commenced on positive airway pressure treatment.MethodsAll pre-bariatric surgery patients referred to the sleep clinic for review after an abnormal screening study between 2018 and 2022 were included. We collected data on their sleep study results, anthropometrics, co-morbid medical conditions, clinical observations, spirometry and arterial blood gas (ABG). Patients commenced on therapy were followed-up longitudinally and compliance data collected via remote monitoring.ResultsA total of 116 patients were included [age: mean ± standard deviation (SD) 48.8±10.8 years; body mass index (BMI) 49.2±8.5 kg/m2; Epworth Sleepiness Scale (ESS) 8.7±5.1 points]. Fifteen patients (12.9% of cohort) were diagnosed with hypercapnic respiratory failure (pH 7.40±0.02; pO2 11.00±1.04 kPa; pCO2 6.15±0.08 kPa). Compared to eucapnic obstructive sleep apnoea (OSA) patients, they were older (51.1 vs. 48.5 years; P=0.311), had a higher BMI (51.5 vs. 48.9 kg/m2; P=0.266), more likely to be female (66.7% vs. 53.5%; P=0.275) and had a higher ESS score (10.4 vs. 8.5 points; P=0.177). On binomial regression analysis insulin dependent diabetes was the only patient characteristic of significance with prevalence increased in patients with OHS (26.7% vs. 8.9%; P=0.042). Forced vital capacity (FVC) and oxygen saturation (SpO2) cut-offs demonstrated high specificity (96.8%) but low sensitivity (13.3%) to diagnosed hypercapnia. Fifty percent of the patients with hypercapnia required bi-level ventilation. On follow-up 44.9% of patients were compliant with therapy (>4 hours usage/night).ConclusionsIn minimally symptomatic patients living with severe and complex obesity who have an abnormal overnight oximetry, over 1 in 10 demonstrated chronic respiratory failure. Clinic spirometry and daytime SpO2 excluded those with hypercapnia. Overall adherence to prescribed therapy is low. Screening, appropriate pre-operative optimisation and peri-operative planning are important in preventing complications in this patient cohort.

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Dataset Information

Language Matters: Patients' Preferred Terms for Discussing Obesity and Disordered Eating with Health Care Providers After Bariatric Surgery.

Objective

Methods

Results

Conclusions

Publications

Language Matters: Patients' Preferred Terms for Discussing Obesity and Disordered Eating with Health Care Providers After Bariatric Surgery.

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