interfere with weight loss outcomes, 72,102-104 and contribute to patients selecting potentially riskier weight loss interventions and higher ideal weight loss goals.105 However, supporting patients with ways to cope with stigma may be able to facilitate weight loss outcomes.106 Research Highlight In a 2014 study,103 adults in primary care were surveyed about their perceptions of being judged about their weight from their health care providers. Findings showed that, Patients who perceived negative judgment from their provider were less likely to achieve a ≥10% weight loss, compared to those who did not feel judged. 15 Weight bias, stigma, and discrimination Negative consequences across multiple domains of life • Poor access to & delivery of health care • Diminished income & education • Harmful impact on physiology • Reduced use of health care • Diminished self-esteem Poor health outcomes • Elevated risk for disease • Psychological disorders • Diminished social support • Poor recovery from disease Morbidity & Mortality Part 2: Understanding How Weight Bias Impacts Health The negative impact of bias on income, education, health care, psychological well-being, and physiology, can reduce the quality of life for persons with obesity, increase their risk for worse life outcomes, and exacerbate obesity. In summary, weight bias contributes to a range of adverse health behaviors and outcomes. Taken together, these consequences may impair health in ways that increase morbidity and mortality. 16 Reaction % of parents* Be upset/embarrassed 37% Seek a new doctor 35% Avoid future appointments with doctor 24% How can I support healthy behavior changes for a child with overweight without reinforcing their previous experiences with weight bias?112,113 Children with overweight and obesity are frequently teased and bullied.29 Research suggests that in comparison to other forms of victimization, parents are most concerned about weight-related teasing and bullying,107 and teachers view weight-based bullying to be the most problematic form of bullying in the classroom.108 Despite many parents identifying their physicians to be the best source for addressing their child’s weight, some parents leave the doctor’s office unsatisfied for reasons including feeling blamed for not providing a healthy diet and causing their child’s overweight.10,110,111 ü Provide specific strategies that help parents monitor and measure improvements in their child’s eating and exercise behaviors. Part 2: Special Consideration: Weight Bias in Youth ü Emphasize positive habits that their child enjoys or already engages in. ü Use sensitive language to describe the child’s weight-related health. Research Highlight “If your doctor referred to your child’s weight in a way that makes you feel stigmatized, how would you react?”111 *reporting “likely” or “very likely” 17 Part 2: Special Consideration: Weight Bias in Youth Using a sensitive communication approach for discussions about weight is key to establishing a relationship with families so that they can be better informed and supported in their efforts for effective weight management. During your discussion, keep in mind,111 Appropriate, neutral weight-related terminology Non-judgmental attitude that avoids blaming or shaming parents 1. 2. Weight BMI Morbidly Obese Fat Resources of helpful communication strategies For use by pediatricians: How to Talk to Parents Having a Productive Talk with Parents To share with parents: Be Informed and Assertive Addressing Weight Bias at the Doctor's Office Talking with the Doctor about my Child Part 3: Increasing Self-Awareness of Weight Bias Overview Increasing awareness of personal attitudes about body weight is an important first step in understanding and reducing weight bias. Even the most enlightened, intelligent, and well-intentioned professionals may harbor some bias, often in subtle ways that they are unaware of. This portion of the course will help you assess your personal attitudes about body weight and people with obesity. Becoming aware of personal attitudes can help to improve communication with patients of diverse body weight. The following pages contain questions and resources for self-reflection. Please take the time to read each question and consider your answer. Am I immune to weight bias? How does my practice reflect my own attitudes? In what ways might I be unintentionally communicating bias? 2 Part 3: Implicit and Explicit Weight Bias Although health providers may not intentionally express their biases, research suggests that some physicians and medical students unconsciously hold negative beliefs about individuals with obesity (called implicit weight bias).1,3-8 In one study of over 2,000 health providers, both strong explicit and implicit weight biases were pervasive; in fact, physicians exhibited weight biases to an extent comparable to the general population. 3 Such biases can affect the quality of patient-provider relationship and have implications for patients’ health care experience and outcomes. How might implicit weight bias affect patient-provider relationship? · Sit further away · Use less visual contact · Be less engaging · Share less healthrelated information During medical visits with patients with overweight or obesity, may Physicians with greater implicit weight bias Even without the intention to discriminate, some research9 shows that implicit attitudes may result in discriminatory behavior. 3 Part 3: Persistence of Weight Bias in Health Care Over time…