Weight Bias in a Weight Management Program? You Bet

| June 1, 2018

A Message from Dr. Christopher Still

Christopher Still, DO, FACN, FACP, Co-Clinical Editor, Bariatric Times; Medical Director for the Center for Nutrition and Weight Management, and Director for Geisinger Obesity Research Institute, Geisinger Medical Center, Danville, Pennsylvania.

Dear Colleagues,

I recently heard an excellent lecture on weight bias by Dr. Scott Kahan.  He presented to a room filled with obesity medicine physicians and bariatric surgeons. I initially thought, “He is preaching to the choir here,” but, in fact, I learned we all have some degree of weight bias/stigma—even me!

Weight bias simply refers to negative stereotypes directed toward individuals affected by excess weight or obesity. This, in turn, often leads to prejudice and discrimination. Given that the majority of our patients have excess weight or obesity, this is an important concern that no individual in your program can afford to ignore. Thus, we have an opportunity to educate everyone who cares for our patients.

Research demonstrates that patients with obesity frequently feel stigmatized in healthcare settings. These negative attitudes have been reported among all provider types—physicians; nurses; dietitians; psychologists; fitness professionals; and medical students, residents, and fellows. Moreover, similar attitudes have been demonstrated among healthcare office and support staff. In our field especially, we want to recognize this bias/stigma exists and provide awareness and education to mitigate it.

The following are ways in which we can reduce weight bias:

Identify our own biases. Project Implicit® (www.implicit.harvard.edu) is a great self-survey on weight bias. This free site evaluates our biases to a whole host of items including weight. I would encourage you and your staff to take this short assessment. It was eye-opening for me.

Implement sensitivity training for all staff. At Geisinger, we recently mandated sensitivity training for all employees caring for bariatric surgery patients during their hospital stay. This includes hospital staff outside of our bariatric program.

Institute patient first language when referring to patients affected by obesity. See my editorial message in the February 2018 issue of Bariatric Times on this important topic.

Educate colleagues on avoiding stigmatizing or blaming words like “obese,” “morbidly obese,” or “fat.” Replace with words like “unhealthy weight” or “high body mass index.”

Educate your staff and medical colleagues that obesity is a complex disease with multiple complex etiologies and not a lack of discipline or willpower.

Taking a proactive approach to address and eliminate weight bias, even in your weight management/surgical practices, can only improve the great care you and your staff are delivering to patients with obesity. I encourage you to learn more about weight bias and stigma by visiting the websites for the Obesity Action Coalition (www.ObesityAction.org) and the UConn Rudd Center for Food Policy and Obesity (www.uconnruddcenter.org).

I hope you all have a great month. I look forward to seeing many of you at the American Society for Metabolic and Bariatric Surgery (ASMBS) Weekend in New York, New York.

Sincerely,

Christopher Still, DO, FACN, FACP 

 

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