Psykosociale konsekvenser af fedme Berit Lilienthal Heitmann, professor, PhD Institut for Sygdomsforebyggelse, Københavns Universitetshospital, RegionH blh@ipm.regionH.dk Research Unit for Dietary Studies at Institute of Preventive Medicine www.kostforskning.dk

Antallet af fedmerelaterede kontakter: 177.703. Omkostningerne forbundet med disse: 1.024 mio.kr. (663 mio. kr. -1.299 mio.kr.) Svarende til 2,8% (1,8% - 3,6%) af de danske somatiske sygehuses driftsomkostninger Jensen AW et al Sygehusomkostninger i forbindelse med svær overvægt Ugeskr Læger 2007;169(33):2634

Bamgbade OA et al. Postoperative Complications in Obese and Nonobese Patients. World J Surg (2007) 31: 556–560

Livskvalitet Fedme mennesker er lykkelige mennesker. Fedme opleves som et lige så stort stress faktor som alvorlige handicap eller kræftsygdomme. 4 4 4

Psykosociale konsekvenser af fedme fordomme, stigmatisering, foragt, udstødelse, mobning, hån, marginalisering, forskelsbehandling, ringeagt forringet livskvalitet .....

Mean Body-Mass Index of Parents of Four Weight Classes of Adpotees. Stunkard et al, NEJM, 1986;314:193-9

Stigmatization of obese children by teachers More untidy More emotional Less likely to succeed More family problems Lack of self-control Have psychological problems Newmark-Sztainer et al, Price et al,

Stigmatisering af fede børn Børn helt ned til 3-års alderen har negative holdninger om fede legekammerater Børns negative holdninger til fede kammerater øges som børnene bliver ældre Forældre har ligeledes negative holdninger overfor fede børn (både egne og andres), som kommer til udtryk både i tale og handling Schwartz & Puhl, 2003

Stigmatization/discrimination from family and peers Peronard J & Heitmann Bl, Obes Rev. 2008 Nov;9(6):522-34.

Stigmatisering af fede voksne Ukendte personer Familie Bekendte/kolegaer Sundhedsvæsenet Arbejdsmarkedet Schwartz & Puhl, 2003

Neither agree nor disagree to lose weight After viewing pictures of male/female subjects of varying BMIs, physicians were asked, if they agreed with the statement ‘...patient should be encouraged to lose weight’ Men Women BMI 32 p<0.05 BMI 28 BMI 25 p<0.05 Strongly disagree to lose weight Neither agree nor disagree to lose weight Strongly agree to lose weight Anderson C et al, 2001, Obesity Research 9(4) 257

Relationship between BMI and 8 year risk of Type 2 diabetes 93 100 Women Men 75 54 42 Age-Adjusted Relative Risk 50 40 28 21 25 8 16 3 4 5 12 2 7 1 1 1 2 4 < 22 < 23 23 - 23.9 24 - 24.9 25 - 26.9 27 - 28.9 29 - 30.9 31 - 32.9 33 - 34.9 35 + Body Mass Index (kg/m2) Chan J et al. Diabetes Care 1994;17:961. Colditz G et al. Ann Intern Med 1995;122:481.

Tynd, veluddannet og mand...

Educational Level, Occupational Class, and Income, by BMI Group (n=4385)  Sarlio-Lähteenkorva,S. Am J Pub Health, 2004:94(3);468-72

Men’s age-adjusted annual income, by educational attainment within different BMI groups (n= 2315) Sarlio-Lähteenkorva,S. Am J Pub Health, 2004:94(3);468-72

Women’s age-adjusted annual income, by educational attainment within different BMI groups (n=2070) Sarlio-Lähteenkorva,S. Am J Pub Health, 2004:94(3);468-72

The negative cues and attitudes towards obese women has economic consequences. Obese (educated) women earn less.

I want you to go home and stop smoling and loose 20 kilos. Then I want you to come back and tell me how the he.. You managed! 488