their primary care physicians. 46 A lack of trust between patients and physicians can affect patient health outcomes such as use of preventive health screenings.47 Thus, it is important for physicians to be aware of how their weight-related attitudes and beliefs affect their personal interactions with patients. Research43-45 suggests that patient-provider relationships with, may… - Use of preventive health services - Understanding and adherence to medical regimes - Overall patient satisfaction - Control of HbA1c levels, among patients with diabetes patients’ trust, rapport, and communication Compared to those who did not feel judged, patients who felt stigmatized about their weight were 45% less likely to report high trust in their primary care physician. 14 Dietitians have demonstrated biased attitudes towards patients with overweight and obesity, while dietetic students report levels of weight bias comparable to that reported in the general US population. 48-51 Some registered dietitians report,50,52 · Beliefs that emotional problems cause obesity · Ambivalence about patients’ compliance with weight loss programs Part 1: Dietitians Among dietetic students, research has documented that patients’ weight can bias students’ health evaluations and perceptions. Compared to non-obese patients, students perceive patients with obesity as,48 · Less likely to comply with treatment recommendations · Having poorer diet quality and health status A study of 182 dietetic students surveyed participants’ extent of agreement with negative descriptors of people with obesity.48 Findings indicate weight bias even among dietetic students. % agreement Negative adjective on Fat Phobia Scale Lazy No willpower Unattractive Poor self-control Slow Overeats Insecure Low self-esteem Lacks endurance 41 41 54 65 68 81 80 75 72 Research Highlight 15 Studies have documented weight bias among psychologists, which can subsequently influence treatment decisions and quality of therapy. In studies that assign therapists to evaluate identical cases about a patient with or without obesity, psychologists often rate the patient with obesity as having, 55,56 · More negative attributes · More severe psychological symptoms · More pathology · Worse prognosis Psychology students similarly assume negative stereotypes and assumptions about individuals with obesity such as their,53,54 o Poor self-control o Tendency to overeat o Low self-esteem o Sedentary lifestyles In fact, these biases may be implicit and automatically triggered when interacting with patients with obesity. A recent study presented psychology students with images of individuals of higher weight or normal weight. Students were faster and made less errors in associating individuals with overweight with negative attributes (e.g., failure, bad, and unmotivated), compared to positive attributes (e.g., successful, good, motivated).57 Part 1: Psychologists 16 Weight bias has also been documented among nurses and trainees, who express stereotypes that patients with obesity are,57-66 · Non-compliant · Overindulgent · Lazy · Unsuccessful “They couldn’t get it in the crook of my arm and they made a comment that if I wasn’t so fat their needles would work.” “I was horrified when she called for the cow canvas.” “But it was like…basically, we don’t want to do anything that is going to expose us to your excess weight!” Part 1: Nurses Research Highlight In one study of 551 registered nurses and trainees,59 believed that patients with obesity should be put on a diet during hospitalization 18% preferred not to care for patients with obesity 16% felt uncomfortable when caring for a patient with obesity 54% Patients reports of weight bias from nurses:63 17 The prevalence of weight bias is evident even among medical students. In fact, medical students report personally engaging in and observing peers, clinicians, and educators making fun of patients with obesity or overweight.69 Research Highlight Part 1: Medical Students Medical students report perceiving patients with obesity as, 65,67,68,70-72 · More depressed · Less compliant with treatment · Unwilling to make diet changes · Lacking in self-control · Unpleasant Despite recent findings that a majority of medical students exhibit implicit (74%) and explicit (67%) weight bias,71 some research suggests that most medical students remain unaware of their weight bias.67 In a 2014 study, health professional trainees including Physician Associate, Clinical Psychology, and Psychiatric Residency, were asked about observations of negative comments and jokes about patients with obesity during training.13 About students report observing weight bias from peers and health care providers. of students report observing weight bias from their instructors. 18 Research Highlight Part 1: Providers’ Personal Weight and Implications As in the general public, overweight and obesity are prevalent among health care providers. Providers’ own body weight can influence their beliefs about their patients of higher weight status, and have implications on their weight management practice and quality of relationship with patients. Research suggests that providers with overweight or obesity may have, 73-77 negative expectations for successful weight management confidence in counseling for lifestyle change perceived responsibility for addressing patients' obesity More Less Less An experiment of 358 adults evaluated the implications of physicians’ body weight on the quality of patient-provider relationship.77 Compared to