Weight bias among health care professionals: A systematic review and meta‐analysis

Abstract

Objective Weight‐biased attitudes and views held by health care professionals can have a negative impact on the patient‐provider relationship and the provision of care, but studies have found mixed results about the extent and nature of bias, which warrants a review of the evidence. Methods A systematic review and random‐effects meta‐analysis were conducted by including studies up to January 12, 2021. Results A total of 41 studies met inclusion criteria, with 17 studies providing sufficient data to be meta‐analyzed. A moderate pooled effect (standardized mean difference = 0.66; 95% CI: 0.37‐0.96) showed that health care professionals demonstrate implicit weight bias. Health care professionals also report explicit weight bias on the Fat Phobia Scale, Antifat Attitudes Scale, and Attitudes Towards Obese Persons Scale. Findings show that medical doctors, nurses, dietitians, psychologists, physiotherapists, occupational therapists, speech pathologists, podiatrists, and exercise physiologists hold implicit and/or explicit weight‐biased attitudes toward people with obesity. A total of 27 different outcomes were used to measure weight bias, and the overall quality of evidence was rated as very low. Conclusions Future research needs to adopt more robust research methods to improve the assessment of weight bias and to inform future interventions to address weight bias among health care professionals.

The Effect of an Education Module to Reduce Weight Bias among Medical Centers Employees: A Randomized Controlled Trial

“…a Within groups differences compared to baseline (p ≤ 0.05). [13,14]. In the present study, we aimed to evaluate the effect of an online education module on weight bias and knowledge about obesity among employees of a private chain of medical centers.…”

“…Scientific bodies have recognized obesity as a disease, with the number of people affected by this disease increasing globally [4][5][6][7][8][9]. However, it has been reported that substantial proportions of health professionals from various health disciplines hold negative attitudes, beliefs, and behaviors towards people with obesity (PwO) [10][11][12][13][14]. Expression of negative attitudes, beliefs, and behaviors towards PwO among health professionals could include poor communication, spending less clinical contact time, providing less needed information, missing diagnoses, using inappropriate medical equipment, and attributing a considerable part of patient health issues to their excess weight [10,11,15].…”

“…Expression of negative attitudes, beliefs, and behaviors towards PwO among health professionals could include poor communication, spending less clinical contact time, providing less needed information, missing diagnoses, using inappropriate medical equipment, and attributing a considerable part of patient health issues to their excess weight [10,11,15]. Experiencing weight bias, stigma, and discrimination by patients may lead to adverse physiological and psychological outcomes such as depression, anxiety, stress, feeling embarrassed about their body size, decreased self-esteem, substance use, and lower quality of life [10,[13][14][15][16][17]. Moreover, patients who internalize these negative beliefs about themselves may develop less adaptive coping responses, including low compliance to medical advice, lack of trust, and avoidance, delay, or cancellation of health services [10,12,18,19].…”

“…Moreover, patients who internalize these negative beliefs about themselves may develop less adaptive coping responses, including low compliance to medical advice, lack of trust, and avoidance, delay, or cancellation of health services [10,12,18,19]. Therefore, strategies to reduce weight bias, stigma, and discrimination among healthcare professionals are needed to create a more accepting, respectful, and effective treatment environment for PwO [10][11][12]14]. However, well-designed experimental research to find effective strategies to reduce weight bias, stigma, and discrimination among practicing health professionals is lacking, and no single preferred approach exists [11,14,[20][21][22][23][24][25].…”

“…Therefore, strategies to reduce weight bias, stigma, and discrimination among healthcare professionals are needed to create a more accepting, respectful, and effective treatment environment for PwO [10][11][12]14]. However, well-designed experimental research to find effective strategies to reduce weight bias, stigma, and discrimination among practicing health professionals is lacking, and no single preferred approach exists [11,14,[20][21][22][23][24][25]. The majority of the trials among healthcare professionals were small, included short-term interventions, and showed little or no effect in reducing weight bias [20][21][22][23][24][25].…”