Overcoming Weight Bias in the Management of Patients With Diabetes and Obesity

Weight Bias and Stigma: Public Health Implications and Structural Solutions

“…Weight‐biased attitudes have been documented across a wide range of health care professionals, including physicians, nurses, psychologists, dietitians, health care trainees (e.g., medical students), and even clinicians specializing in eating disorders and obesity (Budd, Mariotti, Graff, & Falkenstein, ; Davis‐Coelho, Waltz, & Davis‐Coelho, ; Phelan et al., ; Puhl, Latner, King, & Luedicke, ; Swift, Hanlon, El‐Redy, Puhl, & Glazebrook, ; Tomiyama et al., ). Health care professionals report having less respect for patients with obesity and believing that they are unmotivated, lazy, and unlikely to follow treatment recommendations (Phelan, Burgess, et al., ; Puhl, Phelan, Nadglowski, & Kyle, ). Due to these negative beliefs, providers may spend less time with patients with obesity, engage in less “patient‐centered communication” (e.g., less rapport‐building), and are more reluctant to perform certain screenings or discuss health with patients (Phelan, Burgess, et al., ; Puhl, Phelan, et al., ).…”

“…Health care professionals report having less respect for patients with obesity and believing that they are unmotivated, lazy, and unlikely to follow treatment recommendations (Phelan, Burgess, et al., ; Puhl, Phelan, Nadglowski, & Kyle, ). Due to these negative beliefs, providers may spend less time with patients with obesity, engage in less “patient‐centered communication” (e.g., less rapport‐building), and are more reluctant to perform certain screenings or discuss health with patients (Phelan, Burgess, et al., ; Puhl, Phelan, et al., ). In survey research, patients report feeling disrespected by unsolicited advice to lose weight (e.g., when a patient seeks medical advice for an unrelated problem), inappropriate or derogatory comments about their weight, and blaming or dismissive statements regarding the challenges of weight loss (Amy et al., ; Puhl, Moss‐Racusin, Schwartz, & Brownell, ).…”

“…Additionally, contact with "standardized" patients with obesity (individuals hired to role-play patient scenarios) within medical school courses may increase empathy and comfort when discussing weight (Phelan, Puhl, et al, 2015;Puhl, Phelan, et al, 2016). For example, one study provided medical students with articles about weight stigma and communication strategies prior to role-playing discussions about weight with standardized patients (Kushner, Zeiss, Feinglass, & Yelen, 2014).…”

Acanthosis nigricans in obese adolescents: prevalence, impact, and management challenges

“…Weight bias, discrimination, and stigmatization against obese individuals are widespread. This is true across different social contexts, including education and employment opportunities, mass media advertising, and even health care encounters 86. Weight discrimination is increasing and has become pervasive.…”

Practical Strategies for Engaging Individuals With Obesity in Primary Care

“…For example, the term obese is consistently rated as least desirable and off-putting by patients. 63,64 In contrast, neutral terms, such as unhealthy weight, are generally preferred and may be perceived as motivating, thereby helping patients feel supported and empowered in their weight management efforts. 63,64 As with other medical conditions, the use of people-first language ("patient with obesity" or "having obesity"), as opposed to condition-first language ("obese patient"), is recommended terminology for both academic and clinical settings.…”