Addressing weight bias
Weight is a sensitive subject, and bias around weight may be more common than you suspect.1
Understanding the impact of weight bias1
Weight bias is described as negative attitudes toward individuals affected by excess weight or obesity that can lead to subtle and overt forms of discrimination.1
People with obesity may also experience depression, low self-esteem, and body-image distress.5
Perceived weight bias isn’t isolated to the workplace, media, school, and family—a high percentage of patients with obesity perceive experiencing weight bias by medical professionals at least once.6
Study enrolled 2,671 patients broken into 2 subsamples. Sample 1 had 2,449 adult women, and Sample 2 was a matched sample of adult men and women that was separated by gender to investigate gender differences. Both groups completed an online self-reported questionnaire. Topics included frequency of weight stigmatization and bias, coping responses to deal with the bias, most common sources of the weight bias, symptoms of depression and self-esteem, attitudes about weight and obesity, and binge—eating behaviors. The results above are from Sample 1 of the study.6
Even the best intentioned HCPs may exhibit weight bias.7
Strategies to address weight bias8,9
Obesity is a serious disease, and it should be treated that way; a formal diagnosis of obesity is associated with better outcomes for patients.8
Patients with obesity may feel more comfortable seeking professional help when perceptions of bias in the health care setting are reduced9
Although the majority of the weight bias literature cites female respondents, that does not mean that men with obesity do not experience the same bias as well
Creating a welcoming environment
Unaccommodating office equipment and assessment tools may have a negative impact on your patients, but there are ways to foster comfort.9
- Open-arm chairs that can support people of all sizes
- Firm sofas that can support more than 300 pounds
- Weight-sensitive reading materials
- Large-sized gowns
- Large and extra-large adult arm and thigh blood pressure cuffs
- Wide examination tables, bolted to the floor
- Sturdy armless chairs
- Wide-based scale that measures greater than 350 pounds
- Meets established accuracy requirements
- Accessible for individuals with disabilities
- Situated in a physical location that offers privacy and confidentiality
Training your office staff
You can start addressing weight bias by:
Increasing awareness about the negative consequences of weight bias of individuals with obesity
Using person-first language to avoid perceptions of bias
Encouraging colleagues to adopt a more empathetic understanding of their patients with obesity and avoiding the appearance of judgement
Being more sensitive to situations that could cause embarrassment, such as weighing in a public area
Emphasizing lifestyle goals, including healthy nutrition, increased physical activity, and behavioral changes
Words matter when it comes to discussing weight with your patients. Here are some preferred terms by patients with obesity10:
Your leadership can be the difference
Can excess weight impact health?
References
1. The Obesity Society. Obesity, bias, and stigmatization. Accessed March 2, 2021. http://www.obesity.org/obesity/resources/facts-about-obesity/bias-stigmatization
2. Adult obesity facts. Centers for Disease Control and Prevention. Accessed March 1, 2021. https://www.cdc.gov/obesity/data/adult.html
3. US Census Bureau. QuickFacts: United States. Accessed March 1, 2021. https://www.census.gov/quickfacts/fact/table/US#viewtop
4. Andreyeva T, Puhl RM, Brownell KD. Changes in perceived weight discrimination among Americans, 1995-1996 through 2004-2006. Obesity (Silver Spring). 2008;16(5):1129-1134.
5. Puhl R, Heuer CA. The stigma of obesity: a review and update. Obesity (Silver Spring). 2009;17(5)941-964.
6. Puhl RM, Brownell KD. Confronting and coping with weight stigma: an investigation of overweight and obese adults. Obesity (Silver Spring). 2006;14:1802-1815.
7. Schwartz MB, Chambliss HO, Brownell KD, Blair SN, Billington C. Weight bias among health professionals specializing in obesity. Obes Res. 2003;11:1033-1039.
8. Dhurandhar NV, Kaplan LM, Kyle TK, et al. Poster presented at: Obesity Week 2017; October 29-November 2, 2017; Washington, DC.
9. Obesity Action Coalition. Understanding obesity stigma. Accessed March 1, 2021. http://www.obesityaction.org/wp-content/uploads/UOS_1-26-18-wo-bleed.pdf
10. Wadden TA, Didie E. What’s in a name? patients’ preferred terms for describing obesity. Obes Res. 2003;11(9):1140-1146.
