The fine line between health promotion and the reproduction of fatphobic speech by doctors

Abstract

Introduction: Body weight control is essential for the treatment and prevention of the main comorbidities in the world, such as hypertension, dyslipidemia and obesity. However, medical guidelines regarding weight loss are often not evidence-based or clearly communicated, and they also do not take into account the psychological and social conditions of patients, as dictated by the values of health promotion, but rather, approached in a prejudiced and shallow way. This study seeks to answer the following question: Is the manner physicians deal with their patients’ obesity a way of promoting health or of propagating even more unfavorable clinical outcomes in this population? Objective: This study aimed to review the literature regarding medical fatphobia and its impacts on the patient. Method: This is an integrative literature review, carried out in January 2022. The data search took place from the year 2007 to January 2022. The following databases were used: SciELO, Lilacs and PubMed. The following descriptors were used in the search for articles: Obesity, Overweight, Social Stigma, Social Discrimination, Bullying, Fatphobia, Weight Bias, Medication Adherence, Therapeutic Alliance, Health Professionals, Binge-Eating Disorder. Result: The 16 selected articles were classified according to type of study, year, place, target audience and results, and then critically analyzed. Conclusion: Although it is crucial for doctors to warn their patients about weight loss, these guidelines, when made in a prejudiced, rude way and without well-defined goals, make them not interested in taking care of their own health, or even trying to lose weight without professional support. Therefore, instead of fighting obesity, its current management is responsible for aggravating it and even developing other comorbidities, such as depression.