Obesity Stigma in Clinical Practice: Ask Yourself these 8 Questions
Weight bias themes in primary care are the subject of contemporary research. Which options you choose to these 8 questions may offer insight into your own unconscious prejudices.
Health care professionals, like persons in all walks of life, may hold strong negative attitudes and stereotypes about individuals with obesity. These negative attitudes, whether conscious or not, can have a negative impact on clinical encounters, quality of care, and patient outcomes.
This quick quiz is based on current research into weight bias among health care providers, and particularly those in primary care. The answers you choose may give you insight into your own personal prejudices.
1. What % of US adults with overweight and obesity experience internalized weight bias?
Answer: C. ≈ 40%–50%. Beyond that, about 20% of overweight and obese US adults experience internalized weight bias at high levels.
2. True or False. Severe obesity usually is reversible by voluntarily eating less and exercising more.
Answer B. False. This is a common misconception. Body weight and fat mass are regulated by numerous physiological mechanisms above and beyond voluntary food intake and physical exercise.
Voluntary attempts to eat less and exercise more have only modest effects on body weight in most persons with severe obesity.
3. Which weight bias and patient engagement themes have been identified in primary care practice?
Answer D. All the above. An analysis of weight bias and patients’ engagement with primary care services reported these and other negative themes, including lack of training, ambivalence, barriers to health care utilization, low trust and poor communication, and avoidance or delay of health services.
4. In a recent study of medical professionals, roughly how many agreed that negative attitudes toward patients with obesity is a common problem in healthcare practices?
Answer: D. Two-thirds. Most (68.5%) of the respondents reported that negative attitudes toward patients with obesity is common in medical practices. They cited inappropriate behaviors that included mocking the patient’s appearance, looks of disgust and repulsion, lack of reaction to offensive remarks, and scaring a patient with the necessity to lose weight.
5. True or False. Weight stigma may serve as a barrier to utilization of bariatric surgery for clinically severe obesity.
Answer: A. True. A recent article cited shared medical decision-making as a strategy to promote appropriate conversations between patients and providers that may contribute to increased utilization of bariatric surgery.
6. True or False. Weight bias increases patients' ED wait times.
Answer: B. False. A study of obesity bias in an ED setting showed that persons with obesity do not experience longer wait times than those of normal weight. Median door-to-room and door-to-provider times for adults with class 3 obesity were significantly shorter than those for persons in the normal weight category.
7. Which strategies can providers implement in the primary care setting to reduce obesity stigma by improving their own attitudes?
Answer: E. A and C but not B. Providers' frustration with patients who they perceive are harming their own health may elicit strong negative emotions. One study suggests that emotion regulation tools (eg, meditation and deep breathing) may help them reduce stigma by overcoming these negative emotions and improving compassion and other prosocial emotions.
8. True or False. Weight stigma in clinical practice may be reduced by shifting focus from body weight to screening for conditions for which obesity is a risk factor and encouraging behaviors that will improve health and well-being.
Answer: B. True. This strategy may help reduce weight stigma by creating a more welcoming, less threatening environment. Other approaches include adopting patient-centered communication strategies, providing chairs and medical equipment that are usable by patients of all sizes, and conveying a sense of identity safety by providing evidence that diversity is valued.
