Exploring the Climate for Overweight and Obese Students in a Student Health Setting

Pedersen, Peggy; Ketcham, Patricia L.

doi:10.3200/jach.57.4.471-480

Cited by 12 publications

(8 citation statements)

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“…Physician weight counseling is associated with increases in patient desire and attempts to lose weight, 46,47 yet as few as 28.9% of physicians inform obese patients of their BMI category, and even fewer provide weight-related counseling. 48 Given that health providers report feelings of discomfort as a barrier to discussing weight with patients, 49 the current findings offer specific suggestions for providers of preferred, motivating weight terminology that can facilitate patient-provider discussions. Although the present findings were primarily consistent across socio-demographic characteristics, it is also important to recognize variability in patient preferences.…”

Section: Discussionmentioning

confidence: 93%

Motivating or stigmatizing? Public perceptions of weight-related language used by health providers

2012

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BACKGROUND:Research demonstrates that health providers express negative attitudes toward overweight and obese patients that can be conveyed through weight-related language, yet little is known about people's perceptions of weight-related language used by providers. The current study examined public preferences and perceptions of weight-based terminology used by health-care providers to describe excess weight. METHOD: A national sample of American adults (N ¼ 1064) completed an online survey to assess perceptions and preferences associated with 10 common terms to describe body weight. Participants rated how much they perceived each term to be desirable, stigmatizing, blaming or motivating to lose weight (using five-point Likert scales), and how they would react if stigmatized by their doctor's reference to their weight. RESULTS: The terms 'weight' (3.43, 95% confidence interval (CI) 3.35-3.50) and 'unhealthy weight' (3.24, 95% CI 3.15-3.33) were rated most desirable, and the terms 'unhealthy weight' (3.77, 95% CI 3.69-3.84) and 'overweight' (3.51, 95% CI 3.43-3.58) were rated most motivating to lose weight. The terms 'morbidly obese', 'fat' and 'obese' were rated as the most undesirable (95% CI 1.61-2.06), stigmatizing (95% CI 3.66-4.05) and blaming (95% CI 3.62-3.94) language used by health providers. Notably, participant ratings were consistent across socio-demographic variables and body weight categories. A total of 19% of participants reported they would avoid future medical appointments and 21% would seek a new doctor if they felt stigmatized about their weight from their doctor. CONCLUSION: This study advances our understanding of why individuals prefer particular weight-related terms, and how patients may react if their provider uses stigmatizing language to refer to their weight. It also offers suggestions for practical strategies that providers can use to improve discussions about weight-related health with patients.

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Section: Discussionmentioning

confidence: 93%

Motivating or stigmatizing? Public perceptions of weight-related language used by health providers

2012

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“…Correspondingly, the stigmatisation associated with overweight and obesity (Bissell, Peacock, Blackburn, & Smith, 2016;Lupton, 2013) was taken seriously by most GPs in this study. While a related cautiousness in approaching the topic of overweight can be seen to hinder conversations between primary health care physicians and patients (Hansson et al, 2011;Michie, 2007;Pedersen & Ketcham, 2009), most of the GPs in this study prioritised the creation of safe, inclusive environments for patients. The focus for these practitioners was on the contexts and needs of their individual patients.…”

Section: Discussionmentioning

confidence: 99%

“…This concurs with research (Peters et al, 2013;Puhl & Brownell, 2001) finding that GPs' low self-efficacy and doubt in their ability to "treat" overweight and obesity are key obstacles to engaging patients in discussions about weight. Other studies have also found that GPs avoid discussions about overweight with their patients because of a concern that such discussions may cause offence and/or provoke a negative reaction (Hansson, Rasmussen, & Ahlstrom, 2011;Michie, 2007;Pedersen & Ketcham, 2009).…”

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confidence: 99%

Talking about overweight and obesity in rural Australian general practice

Malatzky

Glenister

2018

Health Soc Care Community

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As many patients’ sole point of contact with the health care system, primary health care physicians (general practitioners [GPs] in Australia) are often positioned as key players in responding to rates of overweight and obesity in dominant public discourse. However, research from Western industrialised countries suggests that GPs may not be prepared for, or confident in, having conversations about overweight and obesity with patients. Little attention has been given to this topic in Australia, particularly in the context of rural health. The aim of this study was to understand how GPs in two rural settings in Victoria, Australia talk about overweight and obesity with patients. Working from a multidisciplinary perspective, a qualitative study design was adopted, and semi‐structured interviews were conducted with seven GPs and seven GP patients living in two rural communities between January and April, 2016. Data was coded manually and thematic analysis was used to explore the data. The findings of this study support the argument that, in contrast to dominant messages within public health discourses, GPs may not be best placed to act as the primary actors in responding to overweight and obesity as they are constructed in epidemiological terms. In fact, the perspectives of GP study participants suggest that to do so would compromise important dimensions of general medical practice that make it simultaneously a human practice. Instead, more balanced, holistic approaches to discussing and responding to overweight and obesity with patients could be taken up in local, interdisciplinary collaborations between different health professionals and patients, which utilise broader social supports. Focussing on long‐term, incremental programs that consider the whole person within their particular socio‐cultural environment would be a productive means of working with the complexities of overweight and obesity. However, structural level changes are required to ensure such initiatives are sustainable in rural practice.

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“…Implementing stigma reduction efforts during medical training may help prevent and attenuate weight biases that may otherwise remain and potentially worsen in the absence of intervention. The limited work that has documented weight bias among students in medical disciplines suggests that students hold similar biases as health providers , including qualitative research showing that medical students feel that it is socially acceptable to make fun of patients with obesity . Most recently, one study found that 33% of medical students self‐reported moderate to strong explicit weight bias, and 39% exhibited implicit obesity bias, most of whom (67%) were unaware of their negative attitudes .…”

Section: Introductionmentioning

confidence: 99%

Obesity bias in training: Attitudes, beliefs, and observations among advanced trainees in professional health disciplines

Puhl

Luedicke

Grilo

2013

Obesity

142

108

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Objective This study examined weight bias among students training in health disciplines and its associations with their perceptions about treating patients with obesity, causes of obesity, and observations of weight bias by instructors and peers. Design and Methods Students (N = 107) enrolled in a post-graduate health discipline (Physician Associate, Clinical Psychology, Psychiatric Residency) completed anonymous questionnaires to assess the above variables. Results Students reported that patients with obesity are a common target of negative attitudes and derogatory humor by peers (63%), health-care providers (65%), and instructors (40%). Although 80% of students felt confident to treat obesity, many reported that patients with obesity lack motivation to make changes (33%), lead to feelings of frustration (36%), and are noncompliant with treatment (36%). Students with higher weight bias expressed greater frustration in these areas. The effect of students’ weight bias on expectations for treatment compliance of patients with obesity was partially mediated by beliefs that obesity is caused by behavioral factors. Conclusions Weight bias is commonly observed by students in health disciplines, who themselves report frustrations and stereotypes about treating patients with obesity. These findings contribute new knowledge about weight bias among students and provide several targets for medical training and education.

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Exploring the Climate for Overweight and Obese Students in a Student Health Setting

Abstract: The authors make recommendations for improving the health care climate for overweight and obese students.

Cited by 12 publications

References 0 publications

Motivating or stigmatizing? Public perceptions of weight-related language used by health providers

Motivating or stigmatizing? Public perceptions of weight-related language used by health providers

Talking about overweight and obesity in rural Australian general practice

Obesity bias in training: Attitudes, beliefs, and observations among advanced trainees in professional health disciplines

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