Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0277787 (stigma)
 13,352 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Morbid obesity is a major health problem in this country and throughout the world. In addition to its social stigma (in the western world), obesity exacerbates several disease states such as diabetes, hypertension, cardiac disease and restrictive lung disease. When effective medical treatment of obesity becomes available, it will depend in part upon understanding the physiologic factors that control satiety. This review summarizes the information available on brain and gut control mechanisms of satiety. Brain nuclei located in the lateral hypothalamus, ventromedial hypothalamus, and other paraventricular areas are the sites of action for potent neuropeptides, such as cholecystokinin (CCK) and neuropeptide Y, that appear to regulate feeding. Exogenous CCK has been used clinically to decrease meal size in obese patients. The sites of the satiety cascade that are most often manipulated are the gastric and intestinal phases. Physiologic gastric distension is a potent inhibitor of feeding, whereas the intermeal interval may be regulated by intestinal signals released by food in the gut. Jejunal-ileal bypass has fallen from favor and has been replaced by gastric restrictive procedures that create a small proximal gastric pouch that empties into the small bowel (gastric bypass) or the distal stomach (gastroplasty). These operations rely partially on their ability to produce gastric distension in the proximal gastric pouch at an early stage during a meal. Thus, failure results if the pouch compensates by distending or if the stoma widens with subsequent loss of slow emptying. Improved medical and surgical treatment will be designed to intervene at specific sites of the satiety cascade as knowledge of the physiologic control mechanisms of satiety increases.
 ...
PMID:Physiologic approaches to the control of obesity. 229 39

Morbid obesity is an increasingly common healthcare problem, and providers and patients currently face numerous challenges in dealing with this problem effectively. Issues addressed in this article include the effect of stigma, the need for more evidence regarding effective management options, and the declining insurance coverage for bariatric surgery. The role of bariatric surgery in effective management of morbid obesity is discussed, along with the effect on and possible reasons for declining coverage. A comparison between benefits and coverage for bariatric surgery and angioplasty/stent placement is included.
 ...
PMID:Current issues and challenges in the management of bariatric patients. 1630 5

Morbid obesity is associated with severely invalidizing symptoms and a strong stigma, which restrict the management of daily life. The handicaps of morbid obesity are so severe that patients are ready to accept even inconvenient adverse effects or high risks from the treatment. Seeking antiobesity surgery is mainly done for health reasons, but is perceived to have a broad effect on functional capacity, self-image as well as on mental and social well-being. By the help of anti-obesity surgery, many patients not only gain control over eating, but also over other fields of life.
 ...
PMID:[Effects of bariatric surgery on mental and social well-being]. 1999 67

In 2009, the Public Health Agency of Canada (PHAC) provided guidelines about which groups should be given first access to the H1N1 influenza vaccine. These guidelines recommended that people under 65 with chronic health conditions should be among the first groups to receive the H1N1 influenza vaccine. Severe obesity was among the relevant chronic health conditions identified by PHAC. Since health care is under the jurisdiction of the ten Canadian provinces, the provinces were not required to follow these recommendations in their respective mass vaccination campaigns. Only one province (Manitoba) followed the PHAC recommendations with respect to severe obesity. Four provinces did not offer early vaccination to this group. Other provinces listed severe obesity as a sequencing category late in the vaccination campaign or placed narrow age restrictions on those who were given early access. This commentary argues that the Canadian provinces demonstrated an ambiguous commitment to the early vaccination of people who were severely obese, and that there is evidence that the stigma of obesity influenced H1N1 influenza vaccine sequencing decisions in many Canadian provinces.
 ...
PMID:The influence of the stigma of obesity on H1N1 influenza vaccine sequencing in Canada in 2009. 2204 4