Professional Stigma on Weight in the Pediatric Care in Italy and Andalusia: Recognize it to Successfully Treat Obesity

Objective
Obesity treatment strategies are often ineffective over the long term either in primary care or in the specialist setting. The universal weight stigma is on the rise and is gaining importance as the cause of the onset, the subsistence and the worsening. Aim of our study is to assess the presence of explicit stigma in the pediatric setting in Italy and Andalusia, in order to increase the awareness and take more effective actions to counteract it. 

Methods
The Likert questionnaire on explicit weight stigma was translated in Italian and Spanish and filled out in 2015-16 by 988 pediatricians enrolled in the Italian Society of Pediatrics and 913 health and nonhealth workers enrolled in a training program for the care childhood obesity in Andalusia. The questionnaire consists of 13 items divided into 3 sub-scales: aversion, fear and role of personal responsibility towards obesity. The results were evaluated and compared by country of origin and in Italy, by catchment area: North, Center and South.
Results
The study reported high stigma scores especially in the Fear and Responsibility sub-scales both in Italy and Spain, with significantly lower Aversion scores and higher in the Fear and Responsibility sub-scales in Spain.
Conclusions
The high pediatric stigma in the two countries justifies the need to activate awareness and reduction actions, as it has been already done elsewhere, perhaps since school and university education, primarily by re-evaluating the causes of the disease and then by activating positive professional pathways. Making the pediatric
professionals aware of weight-stigma, training them towards treatment of family and school derision and non-judgmental obesity management is a priority that may help overweight children.