the number of patients with overweight and obesity has But, weight bias among physicians to be present and can harm patient health outcomes and experiences of health care. Research Highlight In 20011 and 2013,2 over 200 obesity-related professionals (e.g., researchers and clinicians) attending a national obesity conference were surveyed about the extent of their implicit and explicit weight bias. Compared to attitudes of professionals reported in 2001,2 some of the same weight biases had worsened 13 years later: Less implicit bias But… More explicit bias In 2013, more attendees reported · Beliefs that people with obesity are lazier than individuals of lower weight · General bad feelings toward people with obesity In 2013, attendees showed improvements on some aspects of implicit weight bias 4 1. What are my views about the causes of obesity? Do I believe common stereotypes about obesity (e.g., eating too much or lack of motivation) to be true or false? 2. 3. Do I make assumptions about an individual’s character, intelligence, abilities, health status, or lifestyle behaviors based only on his or her weight? 4. How do my views and assumptions about obesity affect my attitude towards individuals of higher weight status? To continue learning about your personal attitudes, you can consult a Rudd Center guide that provides descriptive examples of several validated and structured selfassessment surveys: Assessing Weight Bias Part 3: Questions for Self-Reflection about Obesity Please ask yourself the following questions: 5 How do I feel when I work with patients of different body sizes? 5. Could my attitude about obesity impact my ability to help my patients? 6. 7. Do I consider all of a patient’s presenting problems, in addition to weight? 8. What kind of feedback do I give to patients with obesity? · Do I encourage healthy behavioral changes? · Am I sensitive to the needs and concerns of my patients? 9. What barriers do I face in addressing weight with my patients with obesity? People can often have biases against individuals with obesity that are so automatic that we’re not aware of them. These are called implicit attitudes and they can even contradict the attitudes that we consciously express. Assess your personal implicit attitudes by completing the Implicit Attitudes Test (IAT) You can download a printable version of the IAT here Part 3: Questions for Self-Reflection about your Patients and Practice 1 Part 4: Strategies for Improving Patient-Provider Interactions and Weight Management Counseling Overview: People with obesity frequently feel judged, ashamed and blamed about their body size. It is important that the health care environment be a setting where patients are respected regardless of their body size, and can feel comfortable to ask questions not only about weight management, but a full spectrum of wellness issues. This section will provide you with strategies to help foster respectful communication with patients of higher weight, and to promote productive and positive patient-provider interactions. How can I discuss weightrelated health in a way that is compassionate and motivating for my patients? What are the implications of initiating discussions about weight for my patients’ health care experience and health outcomes? What are some strategies that I can use during patients’ medical office visits to support their efforts for weight management? 2 Most Desirable terms referring to weight Most Undesirable terms referring to weight ü Weight ü Excess weight ü Overweight ü BMI (if thoroughly explained) ü Unhealthy weight û Fat û Fatness û Excess fat û Large size û Weight problem û Heaviness û Obesity û Morbidly Obese û Extremely obese *These items are generally the most preferred by adults when discussing their own weight and by parents when discussing their child’s weight.. Note that these words are more neutral descriptions of body weight. To help patients feel comfortable and motivated for lifestyle changes, it is important to use sensitive and straightforward language about weight: Using appropriate and respectful language about body weight can facilitate a productive and positive conversation with patients. Research has documented that certain words used to describe body weight may be perceived by patients to be stigmatizing and blaming, whereas other terminology may be viewed as motivating and encouraging.1-11 Consider the following words in your discussion: Part 4: Which Words to Use? Most Motivating Unhealthy Weight* Overweight Weight problem Least Motivating Fat Chubby Extremely obese Least Stigmatizing Weight* High BMI Unhealthy Weight* Weight problem Most Stigmatizing Fat Morbidly obese Extremely obese Obese Least Blaming Weight * High BMI Unhealthy Weight* Weight problem Most Blaming Fat Morbidly obese Extremely obese Obese 3 Research Highlight “If your doctor referred to your (or your child’s) weight in a way that makes you feel stigmatized, how would you react?” *proportion of participants indicating ‘likely’ or ‘very likely’ *proportion of participants indicating ‘likely’ or ‘very likely’ In 2010, two national samples of 1,064 adults3 and 427 parents1 were asked about their preferences and perceptions of words used by their health care providers to describe excess weight. Reaction % of parents* % of adults* Be upset/embarrassed 36.8 40.0 Seek a new doctor 34.7 20.0 Avoid future appointments with doctor 24.0 19.0 In a 2012 study, 26 primary care providers were