Weight-Biased Health Professionals and the Effects on Overweight Patients

Abstract

In 2014, the National Health and Nutrition Examination Survey estimated that 35% of adults (body mass index [BMI] >30) and 17% of youth (BMI above 95th percentile of age-and sex-specific charts) in the United States were clinically obese. 1 As obesity continues to increase, sonographers and other medical professionals must be devoted to giving unbiased care with confidence and positive attitudes. Current literature suggests that a large percentage of medical professionals are weight biased or have negative attitudes when treating overweight or obese patients. 2-11 Some physicians simply lack adequate resources and training to provide adequate care for this group of patients. This literature review examines the negative attitudes of medical professionals toward overweight patients, leading to inadequate patient counseling, treatment, and other consequences. By evaluating research focused on this topic, it is hoped that sonographers may be made more aware of the potential for weight bias when interacting with patients and how that can affect patient treatment. Provider Perspectives Provider Perspectives of Causes for ObesityHarvey and Hill 2 surveyed 255 physicians, who listed their five top-rated causative factors for becoming overweight as physical inactivity, food addiction, personality, depression leading to overeating, and a lack of willpower. Less controllable factors such as metabolic defects, fat cell defects, and age were rated lowest as causes for becoming overweight. 2 Thuan and Avignon 3 reported on 607 physicians, who noted poor compliance or lack of willpower in most of their patients. Overall, obese patients were considered responsible for recognizing their weight as a problem and doing something about the situation. 2,3 Provider Attitudes Toward Obese PatientsSabin et al 4 studied 2384 physicians, who showed strong obesity bias regardless of whether the physicians themselves were underweight, normal weight, or overweight. Medical students have shown similar biased attitudes, with results indicating higher negativity when interacting with the obese patient versus the nonobese patient. 4,5 Physicians described obese patients as having unrealistic goals; 66% of 607 physicians believed few patients could lose weight and maintain that loss. 3 Other caregivers have shown similar attitudes; 60% of nurses polled believed 557278J DMXXX10.1177/8756479314557278Journal of Diagnostic Medical SonographyDiGiacinto et al research-article2014Abstract A significant number of Americans are obese. Weight bias and negative attitudes have been documented among medical professionals, and these may cause obese patients to avoid seeking health care, leading to undiagnosed pathology. Some physicians lack adequate resources and patient counseling skills when addressing patient weight management. This may lead to continued weight problems and associated complications for the patient. Many physicians do not address patient obesity with urgency and determination, even though most physicians consider obesity a widespread, problem...

Reducing unintended harm: Addressing weight bias as a social justice issue in counseling through justice motive theory.

“…The unintentional harm of such justice reactions and assumptions about the controllability of weight has not yet been directly examined in research. However, previous research highlights how patients with large bodies are given less time in medical appointments, receive less patient-centered communication, and are provided with fewer treatment options (DiGiacinto, Gildon, Stamile, & Aubrey, 2015;Phelan et al, 2015). Previous research conducted among counseling psychologists found that a client with a large body was regarded as having poorer prognosis and prediction of effort in treatment (Davis-Coelho et al, 2000), which may negatively impact the development of treatment goals.…”

Weight bias as a social justice issue: A call for dialogue.

“…In a critical review of the literature, Phelan et al (2015) suggested that health care professionals tend to exhibit less patient-centered communication, less respect, and spend less time with patients with large bodies and that they dislike and feel unprepared to treat obesity. In recognising a lack of effective treatment engagement with patients with large bodies, DiGiacinto, Gildon, Stamile, and Aubrey (2015) concluded that physicians might not be offering patients advice because they feel they have inadequate resources or believe patients will not comply. Researchers examining the perspectives of patients with large bodies have suggested that perceiving judgment from primary care providers negatively impacted trust in the patient-provider relationship (Gudzune et al, 2014), and that patients have received insensitive comments and gestures from providers (Buxton & Snethen, 2013).…”