Is there weight bias in health care and fitness professionals? If so, identify strategies for increasing sensitivity and combating this bias

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Is there weight bias in health care and fitness
professionals? If so, identify strategies for
increasing sensitivity and combating this bias

• http//www.youtube.com/watch?v7DKFl-Az8i4

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PICTURE THIS

• You are a physician and you have been treating a
  patient suffering from obesity for the past 7
  years. When you first began treating this patient
  they weighed 450lbs since then your patient has
  gained 150lbs and has come to you with several
  complaints about your prescribed treatments along
  with reasons why your treatments have not been
  successful. In addition to these complaints, your
  patient has also informed you that they have been
  recently experiencing a shortness of breath while
  trying to do everyday tasks. As their primary
  care physician you try to explain how the sudden
  shortness of breath could be attributed to the
  excess weight gain. Your patient then requests a
  screening of some sort to make sure that its
  nothing serious, but you assure your patient
  that if they lost weight that the shortness of
  breath would subside. Instead of writing a
  referral for a screening, you prescribe an
  exercise routine and a low-fat diet and schedule
  a follow-up in four months to monitor their
  progress. Later on that week your supervisor
  informs you that the patient went for a second
  opinion and found that the sudden shortness of
  breath was a result of a pulmonary embolism. You
  also learn that your patient has accused you of
  being insensitive and prejudice against fat
  people. As the physician, how do you respond?

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Societal Views

• Obese stereotypes leading to
• stigma
• rejection
• prejudice
• discrimination

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• Weight Bias
• ?
• Vulnerability For
• ?
• Depression, Anxiety, Low Self-Esteem, Poor Body
  Image, Suicidal Acts and Thoughts

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Social and Economic Consequences

• Social rejection
• Poor quality of relationships
• Lower SES (socioeconomic status)
• Worse academic outcomes

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Health Consequences

• Unhealthy eating behaviors
• Binge eating
• Unhealthy weight control practices
• Coping with stigma with eating more and
• Refusing to diet
• Avoidance of physical activity
• Cardiovascular health
• Elevated ambulatory blood pressure
• Increased physiological stress
• Poor quality of life overall

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Discrimination in Health Care

• One of the most documented places for
  discrimination
• Physicians describe their obese patients as
  people who are weak-willed, ugly, or awkward
• Survey of nurses found 28 reported they felt
  repulsion when they see an obese person
• Survey of Michigan physicians stated obesity as
  one of the top most negative patient
  characteristic
• The American Academy of Family Physicians
  surveyed 324 members
• 39 physicians believed that patients were lazy
• 2/3 believed that obese patients lack self-control

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Getting Help

• Often rude and unwelcoming
• When referred for gastric bypass surgery,
  patients are often treated disrespectfully by
  physicians
• Avoidance or delays of medical care and
  assistance
• Survey reported that 12.7 of obese women avoid
  medical appointments because of weight related
  concerns such as stigmatization

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Consequences of discrimination

• Increases the need for medical attention due to
  the increases of health effects
• Chronic progressive diseases
• diabetes mellitus
• osteoarthritis
• cardiovascular disease
• Obesity-related conditions result in 300,000
  deaths/year in the U.S.

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Consequences

• Management of obesity-related medical conditions
  made up 9.4 of the health care expenditure in
  the U.S. in 1999.
• Social Fiscal cost of obesity on society and
  the individual is enormous, and these costs are
  all due to the negative attitudes and
  perspectives that professionals in the health
  care system have toward obese patients

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Unwelcoming environments

• Inadequate equipment
• Unaccommodating waiting rooms
• Insufficient medical supplies

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Creating a Supportive Environment

• Sensitivity when weighing obese patients
• Appropriate medical equipment
• Weight-friendly waiting room
• Appropriate examination room

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Toolkits For Health Care Providers

• Designed to help clinicians across various
  practice settings with easy-to-implement
  solutions to improve delivery and care to over
  weight patients.
• Designed for busy professionals
• Customized for various practice settings
• Designed to Improve provider-patient
  communication
• Assist in providing more sensitive care to
  patients

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Preventing weight bias helping without harming
in clinical practice

• Module 1 Increases Self-Awareness of Weight Bias
  
• Module 2 Improving Provider-Patient Interactions
• Module 3 Overview of Weight Bias in Health Care
  Settings
• Module 4 Office Environment Strategies to Reduce
  Weight Bias
• Module 5 Weight Bias Resources for OBGYN
  Providers
• Module 6 Weight Bias Resources for
  Pediatricians
• Module 7 Weight Bias Resources for Bariatric
  Surgery Clinics
• Module 8 Resources for Overweight Patients

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Patient-Provider Communication

• 1) Acknowledge that patients may truly care about
  their health
• 2) Empower patients to participate in their
  medical care
• 3) Evaluate your own assumptions about what
  constitutes a "good" patient
• 4) Know that behavior change results from
  positive negotiation interaction

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Conclusion

• Despite the many efforts to implement coping
  strategies and an overall decrease in
  stigmatizing obese individuals, psychosocial
  functioning of obese individuals cannot be
  satisfied without substantial transformation on a
  larger scale.
• http//www.youtube.com/watch?vc5cUAdhOwYsfeature
  related
• http//www.youtube.com/watch?vMbJ7hPhyPz0feature
  related