Chocolate Addict

Double Stigma: Addiction and Obesity

What is Vivitrol?A new commentary published in the International Journal of Obesity brings attention to rising concerns about the double stigma of addiction and obesity. Nasreen Alfaris and colleagues present the case of a patient at the Mass General Weight Management Center distressed by being characterized as a drug addict during a bariatric pre-op evaluation. The reason? Her medication history included naltrexone.

Naltrexone has been in the news because of its use as an emergency treatment opioid drug overdoses. It is widely used in addiction medicine and carried by first responders. In mass transit, you will see advertising for it. But it is also part of a new combination drug used for treating obesity, Contrave. And that’s why the patient – who was falsely characterized as a drug addict – had naltrexone in her patient history.

Alfaris points out in her commentary that the medical profession should not accept stereotypes such as arose in this case. She calls for “expanded efforts to educate healthcare professionals, who are all increasingly caring for patients with obesity, about the harmful effects of implicit bias and stigma toward people with obesity.”

The potential for this problem was identified in a 2013 research publication by Jenny DePierre and colleagues. Nicolas Rasmussen argued in a 2012 paper that linking obesity to the “already stigmatised condition of condition of addiction” has the effect of assigning moral blame for obesity.

Stigma and bias get in the way of treating both obesity and addiction. They are deeply rooted in human nature, but ignorance fosters their spread. Patients have a right to expect that healthcare professionals, armed with knowledge, will treat them with respect and objective professionalism.

Click here for the editorial in IJO.

Chocolate Addict, photograph © Shawn Harquail / flickr

Subscribe by email to follow the accumulating evidence and observations that shape our view of health, obesity, and policy.


May 23, 2016