European Union of Private Hospitals

EPHA Awards 2023 – Collaborative Project In Health

Finalist, Policlinico San Pietro, Italy for its National Travelling Exhibiton: raising awereness on Obesity

What makes your project so special?

What’s so special about our project is the opportunity to give a voice to patients and show their lives as an example to others who suffer. The aim is to spread this initiative and create a strong community in order to change the perception of obesity and people suffering from obesity from a stigma to a genuine chronic disease.

Policlinico San Pietro, a private hospital belonging to Gruppo San Donato in the Northern part of Italy, during the 2023, has opened its doors to a collaborative initiative with an obesity patient association. The project aims to guest initiatives in health in order to raise population awareness about specific thematic. For this year the hospital has welcomed in its corridors and hall a traveling photographic exhibition dedicated to people with obesity with the goal of changing the common prospective and stigma about obesity.

Policlinico San Pietro adopts a global perspective for the approach of this disease, that’s why it is considered by bariatric patients one of the best place where to be recovered. There is a bariatric surgery department and a clinical nutrition service and, over the years, it has developed a multidisciplinary team to welcome the obese patient globally with a systemic attitude for the prevention and treatment of obesity. Obesity represents the second preventable mortality factor after smoking and, for this reason, a massive training project has been regarded as a fondamental stone for bridgeing people with obesity to recognize and face their disease on time. Our hospital has decided to host a national traveling exhibition for several months created by the non-profit organization AmiciObesi, to demonstrate how obesity is actually a deep disease and it should be understood widely and well addressed.

Most of people with obesity have difficult relationship not only with their own body but also with every relational context in which they find theirselves involved, so they often prefer being isolated for avoiding confrontation choosing sedentary behaviours and dysfunctional habits. This difficult relationship is not always recognized even within healthcare environments because of obesity is not yet recognized as a chronic disease. In the health sector, a very strong stigma towards the obese subject has been documented among health professionals. Obesity stimulates feelings of reluctance, contempt and discomfort. The obese subject is considered uncooperative, liar and unwilling. Stigma is very dangerous because it induces an avoidance reaction on the part of the patient who interrupts treatment. This slowdown in structuring an effective treatment path for obesity in national care is demonstrated by the fact its diagnosis and treatment is not included in the essential levels of health care so that tackling it means for the patient high direct and indirect costs.

The photographic exhibition is made up of 20 panels showing in black and white the profiles of the protagonists of these life stories and their biographies: people who struggle every day not only with their own weight and self-image, but also with the image that society has picked for them. The objective of this synergic initiative is to defuse the mechanism of social disapproval that gravitates around “being obese” and instead promote a less superficial and stigmatizing vision of obesity as a disease that deserves the same respect and the same access to treatment of other chronic diseases.

Precisely for this reason the hospital, the place for healthcare par excellence, has decided to lend its space to the project, stimulating both the healthcare and political interest for a better and more effective treatment of the patient.

The realization of the photographic exhibition is the result of the efforts of Amici Obesi and had not represented an econmical commitment for the hospital itself. The exhibition “Chiave di svolta – storie e percorsi di persone con obesità / Turning point – stories and paths of people with obesity” is an itinerant initiative which has been coordinated internally between patients, photographers and journalists. From the hospital side have been involved various employees (technical, administrative and health resources) for the realization and development of the project at Policlinico San Pietro. The Bariatric Surgery department, together with the Communication Office, has been the promoters of the synergy with Amici Obesi Association, already present in Italy since 2005.
The AMiciObesi association took care of transporting the panels of the photographic exhibition while the technical staff of the hospital took charge for the preparation of the exhibition, supervising the environment: panels do not have to hide the patients itinerary, maneuvering spaces for emergencies should be respected as well as the safety rules and escape routes. The approval for the use of the private space of hospital was agreed with the board management which also have identified the strategic points for the installation.

The initiative of the photographic exhibition “Turning key-stories and paths of people with obesity” is actually part of a much broader awareness and collaboration initiative of the Gruppo San Donato and previous awareness-raising activities on the territory: it is a collaboration that has existed for 10 years, since the Policlinico San Pietro opened the Bariatric Surgery department. Over the years, the Polyclinic has specialized more and more in the treatment of obesity, so much so that it has also become a pole of attraction for patients outside the region. The professionalism of doctors, surgeons, nurses and health professionals has been enriched and strengthened thanks to the relationship with this association of patients who provided real and immediate feedback on the progress of their journey. Specific solutions were activated through the purchase of beds and armchairs suitable for supporting and containing the size of an obese patient, as well as transport and diagnostic tools that would allow users to maneuver with non-standard circumferences. This was a first step in order not to make the patient and the person feel “out of place” but to feel welcomed in its complexity. Subsequently, aesthetic and functional post-bariatric procedures were introduced because after the surgery and the strong weight loss, the stories of the patients made it clear that the “healing” had not ended: there is a need to get one’s life back in hand, that she changed, just as her social role and perception of the self changed. Psychological support has become fundamental and therefore the Polyclinic has also taken steps to provide these services as a corollary and to complete the treatment path. Furthermore, the AmiciObesi Association has also found in the Policlinico headquarters a place where they can meet periodically to activate their own self-help groups.

Benefits for the patient

From a qualitative point of view the narrative process used for interviewuing patients it is already a benefit. Psychologically, story telling is already therapeutic: “Everyone looks at you and allows themselves to judge you, as if we were freaks from a circus”, “Obesity had deprived me of too many things”, “I unfortunately suffered many episodes of bullying”, “What’s the point of having won all the battles professional and others if you then lose what is the most important for your life”, “I learned to respect myself first of all but above all to make myself respected”, “Food must be a life partner but it must not become the purpose of our life”. These are just some of the testimonies collected by “Chiave di svolta (Key to turning point)” – Stories and paths of people with obesity”.

The initiative of the photographic exhibition held at the Ponte San Pietro hospital is still ongoing at the time on which we present the project (April 2023). For answering to the question about the key results of the initiative and the evidence based data used to collect it we provide a quantitative indication of how many people have been reached through this collaboration, from the Amici Obesi association side and from the clinical activity data of the Policlinico San Pietro.

Associazione AmiciObesi counts on its social Italian platforms 25000 members and 10000 facebook active fans for its initiatives. The mutual aid groups of OBESE AMICI currently active in Italy are located in the following cities: Milan, Bergamo, Turin, Naples, Rome, Palermo.

From the clinical side we can affirm that more than 8000 patients have beneficiated of bariatric surgery in the last decade. The average age of patients is 43 with more than the double male patients. 65% of the target patients are not based in Lombardy or in the territory where the hospital is placed, but they come from other regions of Italy which it means we attract people from other territories becuase of the kind of cure we offer and thanks to the word of mouth “sponsored” by the association Amici Obesi.