Patients' and professionals' experiences and perspectives of obesity in health-care settings: a synthesis of current research.

BACKGROUND: Obesity-related stigma likely influences how obese people interact with health-care professionals and access health care. AIM: To undertake a synthesis of studies examining the views and experiences of both obese people in relation to their health-care provision and health-care professionals in providing care to obese patients. SEARCH STRATEGY: A systematic search of key electronic databases relating to professional or patient experiences of, or perspectives on, obesity was performed in 2008 and updated in 2010. Reference lists of article bibliographies were searched, along with hand searches of relevant journals. INCLUSION CRITERIA: Studies were screened against explicit inclusion criteria and published between 1990 and 2010. Findings were examined and organized thematically. DATA EXTRACTION: Data were extracted focusing on obesity, stigma and access to health-care services. All included studies were subject to critical appraisal to assess the quality of the research.
FINDINGS: Thirty studies were identified. All the studies reported obesity impacting on health-care interactions. Key themes identified were experiences of stigma and feelings of powerlessness, treatment avoidance, psycho-emotional functioning, professional attitudes, confidence and training, variations in health contact time and finally, differences in treatment options and preventative measures.
CONCLUSION: Obesity is a stigmatized condition that impacts negatively on the relationship between patients and health-care providers. Given the increasing prevalence of obesity and the range of therapeutic options available, further work is necessary to understand how the presence of obesity affects health-care interactions and decision making.