The experience of pregnant women with a body mass index &gt;30 kg/m<sup>2</sup> of their encounters with healthcare professionals

Lindhardt, Christina Louise; Rubak, Sune; Mogensen, Ole; Lamont, Ronald F.; Joergensen, Jan Stener

doi:10.1111/aogs.12186

Cited by 53 publications

(89 citation statements)

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“…Overweight male patients perceived poorer quality of care from physicians, including reduced length of consultation (Hebl et al, 2003). Pregnant women with a BMI greater than 30 kg/m 2 reported accusatory responses, a lack of respect and insufficient helpful advice from their general practitioners (Lindhardt et al, 2013). Patients who perceived negative judgement about their weight trusted their health professionals less than those who did not (Gudzune et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

Weight stigma in physiotherapy practice: Patient perceptions of interactions with physiotherapists

et al. 2015

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Some patients perceived negative weight judgements from elements of physiotherapy interactions and environments. Physiotherapists need to be aware of this perception because it may result in poorer patient outcomes and patients avoiding physiotherapy appointments. The results suggest strategies to counteract weight stigma include: adjusting the physical environment of the clinic, portraying an understanding of complex determinants of weight, and employing collaborative, non-judgemental communication styles.

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Section: Introductionmentioning

confidence: 99%

Weight stigma in physiotherapy practice: Patient perceptions of interactions with physiotherapists

et al. 2015

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“…Being categorized as a group with a disease may increase the risk of exclusion and stigmatization of vulnerable groups (National Institute for Public Health, 2007: p. 264). Recent empirical studies show that individuals with obesity in general, and pregnant women with obesity in particular, have a higher prevalence of depression, feelings of low self-esteem and stigmatization in their encounters with healthcare professionals (Lindhardt et al, 2013;Malterud & Ulriksen, 2011). Stigmatization in general creates a gap in social identity, selfawareness and perception by others (Goffman, 1963).…”

Section: Discussionmentioning

confidence: 99%

“…Overweight pregnant women characterize the medical profession's approach to them as lacking respect, engaging in moral condemnation and withholding important information (Lindhardt, Rubak, Mogensen, Lamont, & Joergensen, 2013: p. 1101. Furthermore, in the experience of overweight pregnant women, persons in power do not always recognize the degrading attitudes and behaviour that these women face in health care (Malterud & Ulriksen, 2011: p. 1).…”

Section: Introductionmentioning

confidence: 99%

A Discourse Analysis of Denmark’s Public Health Policy Concerning Overweight among Pregnant Women

Toxvig¹,

Bak

Kristiansen

2017

AASoci

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A recent Danish public health report classified being overweight during pregnancy as a chronic disease, marking a discursive shift from its previous classification as a risk factor for complications in maternal and foetal health. This discursive shift is considered a breach in the discursive field. Health care professionals' approach to governing overweight pregnant women is affected by this breach in the discursive field. Thus, overweight pregnant women have become an issue for medical experts, who are encouraged to use stricter rhetoric when addressing them. This shift also renders pregnant women subject to interventions by medical experts. The aim of this article is to critically analyse recommendations for how health professionals should govern these highrisk individuals and to discuss the implications of such governance for overweight pregnant women. In this study, overweight is classified as BMI ≥ 30 and severe obesity is classified as BMI ≥ 35 on the basis of pre-pregnancy weight. The theory of social construction and the concept of governmentality are applied in a discourse analysis of the prevention of overweight among pregnant women in Denmark. Using a discursive approach, this study analyses central governmental documents that discuss obesity prevention. Three forms of freedom (as discipline, as solidarity and as autonomy) are transferred to three forms of governing and constitute the conceptual framework. The main finding is that public health programmes encourage governing through solidarity, including a palette of autonomy-making, responsibility-making and disciplinary technologies, to promote physical health. Public health programmes conjure an image of overweight individuals as strongly burdened subjectivities. The implications for overweight pregnant women are the formation of new subjectivities, engagement in patient associations, the threat of exclusion from communities and social citizenship and other forms of stigmatization.

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“…More recent studies have reported similar results. For example, a Danish study using a phenomenological approach found that pregnant women with a BMI above 30 felt that they received accusatory responses and judgement in conversations with general practitioners (Lindhardt, Rubak, Mogensen, Lamont, & Joergensen, 2013).…”

Section: Chapter 5: Patient Perceptions Of Weight-related Interactionmentioning

confidence: 99%

“…Overweight male patients perceived poorer quality of care from physicians, including reduced length of consultation (Hebl et al, 2003). Pregnant women with a BMI greater than 30kg/m 2 reported accusatory responses, a lack of respect and insufficient helpful advice from their general practitioners (Lindhardt et al, 2013). Patients who perceived negative judgment about their weight trusted their health professionals less than those who did not .…”

Section: Chapter 5: Patient Perceptions Of Weight-related Interactionmentioning

confidence: 99%

Weight stigma in health: (re)thinking weight in a physiotherapy context

Setchell¹

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The physiotherapy profession increasingly considers weight management to be part of its scope of practice. Ostensibly this may seem like a good idea: popular media and biomedical discourses highlight a global "obesity epidemic", and physiotherapists, considered "experts in movement", may be well placed to help address obesity by encouraging activity. On the other hand, an excessive focus on weight can have negative consequences. A large body of research now highlights negative attitudes towards those who are overweight (weight stigma) among health professionals, including doctors, nurses, dieticians, psychologists and exercise scientists. Yet, despite the size and impact of the profession, there has been little work exploring weight stigma in the context of physiotherapy.My aims are two-fold. First, I investigate weight-related interactions in physiotherapy, and second, I investigate how weight might be (re)thought in this context. The first three thesis chapters provide a theoretical exploration of concepts relevant to weight in physiotherapy. In the introductory chapter I argue that it is helpful to draw from scholarship in critical psychology and the emerging field of critical physiotherapy. In Chapter 2 I consider traditional social psychological theories that provide a social and embodied understanding of weight stigma. However, I outline how these theories are notably apolitical, acultural, ahistorical and lack mechanisms for understanding power in stigma. To address this issue, I introduce post-structuralist perspectives (particularly those of Michel Foucault) that are often used in critical social science. Using a poststructural psychological lens, I critically examine the literature on weight and its associated stigma.As context specific understandings are desirable, I use Chapter 3 to examine the nature of the physiotherapy profession, to determine what might be relevant to "thinking weight" and considerations of stigma. Here I look in depth at this profession, discussing where power, the body, reflexivity and the profession's ontological underpinnings might be relevant to weight-related physiotherapy interactions.In Chapter 4 I outline the empirical approaches I took to further address the aims of the thesis, and discuss their underlying assumptions. Following this, in Chapters 5 to 7 I present three empirical studies, each of which is published in peer-reviewed journals (or under review). In a previous study (described in Chapter 3) I tested weight stigma in physiotherapists using attitude tests in an online survey. I found that participating physiotherapists held explicit and implicit weight stigmatising attitudes similar to those in related professions. Building on this earlier work, Iconducted an inductive thematic analysis of interviews with patients who had experienced weightrelated interactions with physiotherapists (described in Chapter 5). Participants spoke of perceiving weight stigma in a number of elements of physiotherapy interactions, elements of the physiotherapy environment and...

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The experience of pregnant women with a body mass index >30 kg/m² of their encounters with healthcare professionals

Cited by 53 publications

References 22 publications

Weight stigma in physiotherapy practice: Patient perceptions of interactions with physiotherapists

Weight stigma in physiotherapy practice: Patient perceptions of interactions with physiotherapists

A Discourse Analysis of Denmark’s Public Health Policy Concerning Overweight among Pregnant Women

Weight stigma in health: (re)thinking weight in a physiotherapy context

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The experience of pregnant women with a body mass index >30 kg/m2 of their encounters with healthcare professionals

Cited by 53 publications

References 22 publications

Weight stigma in physiotherapy practice: Patient perceptions of interactions with physiotherapists

Weight stigma in physiotherapy practice: Patient perceptions of interactions with physiotherapists

A Discourse Analysis of Denmark’s Public Health Policy Concerning Overweight among Pregnant Women

Weight stigma in health: (re)thinking weight in a physiotherapy context

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The experience of pregnant women with a body mass index >30 kg/m² of their encounters with healthcare professionals