bias in health care settings, and provide you with strategies and resources to help improve delivery of care for patients with overweight and obesity. Additionally, as today’s health providers can help align medical education with future patient needs, different approaches for reducing bias among medical students are discussed. Course Overview This course is designed to increase awareness of weight bias in health care settings, reduce weight bias among health professionals and trainees, and help clinicians improve delivery of care for patients with overweight and obesity. Part 1. Weight Bias in Health Care Part 2. Consequences of Weight Bias for Patients Part 3. Increasing SelfAwareness of Weight Bias Part 4. Improving ProviderPatient Interactions and Weight Management Counseling Part 5. Office Environment Strategies to Reduce Weight Bias Weight bias can affect providerpatient interactions and interfere with clinicians’ delivery of care for patients with overweight and obesity. In treating this patient population, it is important for health professionals to become aware of weight bias and be prepared to effectively address this issue in health care. 3 Introduction: Advocate for a certain group of patients facing disparities in health care, would you? Knock down a barrier that was preventing your patients from receiving high quality of care, would you? Educate your patients to adopt healthy lifestyle changes, would you? Train future health providers to care for all patients in a non-judgmental and respectful manner, would you? If you could… Given the complexity of obesity treatment and the difficulties that many patients face in achieving significant long-term weight loss, it can be challenging for health care providers to effectively help patients who struggle with weight. Health providers often report feeling frustrated1-3 in treating patients with obesity, which can manifest as overt or subtle forms of weight bias towards patients. As a result, patients of higher weight become vulnerable to prejudice and negative stereotypes and experience discrimination because of their weight. Weight Bias Prejudice4 Personal attitudes towards patients because of their overweight or obesity Stereotypes4 Beliefs that patients with overweight and obesity are lacking willpower, lazy, non-compliant with treatment, and lack selfdiscipline to improve health Discrimination4 Unfair and unequitable treatment of patients with overweight and obesity Course Overview 4 Why Care About Weight Bias in Health Care? 1. Research indicates weight bias is common in health care settings. 2. Personal weight biases can affect the delivery and quality of care for patients with overweight and obesity. 3. Experiencing weight bias in health care may lead patients to: û Feel discouraged from making positive lifestyle changes. û Avoid seeking routine or preventive care. û Engage in unhealthy eating and weight control behaviors, and avoid physical activity in response to stigma. û Experience negative psychological consequences. 4. With increased self-awareness of personal attitudes about body weight and by implementing appropriate and sensitive communication strategies with patients with overweight and obesity, bias can be reduced and patients’ quality of care can be optimized. Weight bias is an important clinical concern for all health care providers. Today, in your waiting room… pediatric patients and adult patients have overweight or obesity5 Course Overview – Weight Bias in Health Care 5 \ What does the science say about weight bias? There is considerable scientific research on weight bias. Studies have documented weight bias in multiple domains of life including employment, education, and health care.6-9 Weight bias is also perpetuated in the popular media, news media, and expressed even in interpersonal relationships with family and friends.10,11 While this course focuses on specifically health care practices, it is important to recognize that individuals with obesity experience weight bias in multiple forms throughout many aspects of their daily lives. Let’s begin to review the research on weight bias in health care. Education Employment Media Interpersonal Relationships Health Care Weight bias occurs in Physicians Nurses Dietitians Gynecologists Bariatric Specialists Psychologists Professionals treating eating disorders Medical students Weight bias has been documented in, 6, 12-14 Part 1: Weight Bias in Health Care 6 How Prevalent is Weight Bias among Health Professionals? Studies have documented pervasive Research Highlight negative attitudes and stereotypes toward patients with obesity among health care professionals.1,8,16-19 A 2012 study of over 2,000 medical doctors found moderate to strong implicit anti-fat bias at levels comparable to weight bias documented in the general population.20 Weight biases were present among doctors regardless of their own body weight and gender. Part 1: A 2006 study surveyed 2,449 women with overweight and obesity about their experiences of weight bias.15 Two in three physicians have low expectations for patients achieving and maintaining weight loss.21 Bias from… % of women reporting bias - Doctors 69 - Nurses 46 - Dieticians 37 - Health 21 professionals In fact, over half of the surveyed women reported experiencing bias from doctors on multiple occasions. 7 Part 1: Causal Attributions of Obesity and Weight Bias Weight bias is more likely to be expressed when individuals with obesity are blamed for their weight because of factors such as overeating or