Estigma do peso na organização do cuidado às pessoas com obesidade: Análise a partir das diretrizes mundiais e de trabalhadores da atenção primária à saúde na Bahia.

Abstract

More than 60% of Brazilian adults are overweight, with 25.9% living with obesity. The etiology of obesity is multifactorial, involving genetic, behavioral, socioeconomic, and environmental factors. Although public policies have been implemented to address the issue, stigmatization and fatphobia persist, negatively impacting individuals' physical and mental health. Effective care requires a comprehensive and humanized approach, considering the various dimensions that influence body weight. Our objective is to evaluate how the issue of weight stigma is addressed in international and national clinical guidelines for obesity treatment published between 2000 and 2022, as well as to understand the perception of primary healthcare (PHC) professionals regarding how weight stigma and fatphobia are present in the organization of care for overweight and obese individuals in PHC.

Article 1 consisted of a systematic review with qualitative synthesis of recommendations from national and international clinical guidelines for obesity treatment published between 2000 and 2022, where most clinical guidelines did not emphasize the issue of weight stigma in their recommendations. Despite the limited emphasis on the topic, there are indications of progress in the discourse of guidelines over the years, and the themes of care complexity and weight stigma are beginning to emerge.

Article 2 employs a qualitative-quantitative approach. Information was obtained through a training course for healthcare professionals in 54 municipalities in Bahia. The study includes reflections on the stigma of obesity in the participants' daily work. The research reveals that many PHC professionals consider themselves competent to care for overweight and obese individuals but recognize the potential of their approaches and units to reinforce weight stigma. There is consensus that weight loss is seen as the central focus of care, and personal acceptance of one's own body may influence judgment and care for others. The lack of adequate physical infrastructure in health units and blaming and stigmatizing reflections are points of concern in the care provided. Continuous health education is essential, addressing not only biomedical aspects but also social and psychological ones, along with investments in inclusive infrastructure and public policies that promote holistic health, valuing body diversity to make care more effective and empathetic.