Stigma and shame by medical professionals might be as damaging as as obesity itself

On the second day of the 2021 Brazilian Bariatric Surgery Congress, happening in São Paulo, Dr. Francesco Rubino made a powerful critic against the stigma that obese and diabetic face when seeking for help to both ailments with metabolic surgery. For Dr. Rubino, this shaming sentiment stems from a distorted and sedimented view that the weight gain is only based on their food consumption, not considering other factors that would contribute to this, such as genetics, hormonal imbalances, psychological factors and more.

This stigma can be so harmful that it can interfere in the search for care. According to data presented by Dr. Francesco Rubino, the higher the stigma around obesity, the less prone to search for care for it, and the cost of treatment for it and its consequences add up.


Another misconception pointed out by Dr. Rubino that is used to feed the shaming against patients is that their overweight could be solved with a lifestyle change, including exercise and reducing the calorie intake. According to Dr. Rubio, the general population believe that and this is also the majority consensus between doctors. Research shows that exercise contributes only to 20% of weight loss in an average human.


Lastly, cost and risk are a major argument to not recommend this procedure to obese and diabetic patients that would highly benefit from it. Dr. Rubino points out that even with only 0.2% of surgeries needed in the UK executed, the cost in comparison of this procedure with Osteoarthritis is minimal - 25 million per year for the first one and 1.3 Billion for the second.


When authorized by the health care providers - another barrier that prevents it’s access to it for patients in need of it - the costs of the surgery are regained as the cost of other diseases that are consequences of the main illnesses.


As for the risks, Rubino is not shy of confronting doctors about it “We know that any surgery has risks. Why do we make it sound riskier than any other procedure? We need every resource to combat the obesity epidemic that is rising alarmingly fast”.


Dr. Rubino is just one of the main speakers in this year’s Bariatric Surgery Congress,organized by the Brazilian Society of Bariatric and Metabolic Surgery (SBCBM), with 280 speakers from all over the world presenting their finds in lectures, debates and workshops about the newest protocols for patient care, safer treatment strategies and ways to facilitate the metabolic and bariatric practices in the public health system.