Mitigating Weight Bias in the Clinical Setting: A New Approach to Care

Abstract

Weight bias toward patients in larger bodies is pervasive among health care providers and can negatively influence provider‐patient communication, as well as patients’ behavior and health outcomes. Weight bias has historical roots that perpetuate thinness and Whiteness as the cultural norm. Although weight bias remains socially acceptable in US culture, contributing factors to an individual's body size are complex and multifactorial. Providers and health care systems also consistently use body mass index (BMI) as an indicator of health status, despite its limitations and harmful effects in the clinical setting. This state of the science review presents 8 evidence‐based strategies that demonstrate how to mitigate harm from weight bias and improve quality of care and health outcomes for patients living in larger bodies. Person‐centered approaches to care include (1) eliminating clinical recommendations to lose weight; (2) shifting from a focus on weight to health; (3) implementing a size and weight‐inclusive approach; (4) engaging in weight bias self‐evaluation; (5) creating a welcoming environment for patients of all sizes; (6) seeking permission and learning the patient's story; (7) using weight‐inclusive language; and (8) re‐evaluating clinical guidelines and policies based on BMI. Midwives and other health care providers may benefit from training that re‐imagines the delivery of health care to patients in larger bodies.

Weight Bias Among Certified Nurse‐Midwives and Certified Midwives: Findings From a National Sample

“…1,23 Evidence-based strategies for patient care of individuals with higher body weights that mitigate weight bias and improve provider-patient communication and patient satisfaction have been described in depth elsewhere. 9 In sum, person-centered, trauma-informed strategies to care include (1) eliminating clinical recommendations to lose weight, (2) shifting from a focus on weight to health, (3) implementing a size and weight-inclusive approach, (4) engaging in weight bias self-evaluation, (5) creating a welcoming environment for patients of all sizes, (6) seeking permission and learning the patient's story, (7) using weight-inclusive language, and (8) re-evaluating clinical guidelines and policies based on BMI. Echoing prior calls for health care provider education about weight bias and training to reduce bias in clinical care, 1,23,64 stigma-reduction efforts are needed among perinatal care providers.…”

“…7 Experiences of weight bias and an associated stress response has been described elsewhere. 8,9 Weight bias exists in all facets of society, including the workplace, educational institutions, media, personal relationships, and health care settings. 10 Health care providers, including physicians, medical students, and nurses, have been shown to have implicit and explicit weight bias toward individuals with higher body weights.…”