SESSION 9:
JUSTICE: OBESITY AND STIGMA
Introduction
Health care professionals have an important role to play in addressing health issues of
public health concern such as obesity and diabetes. Individuals with obesity or weight
issues may however be reluctant to seek medical help because of stigma, and perceived or
real discrimination by healthcare professionals. On the other hand, care for these individuals
in the inpatient setting may present unique ethical and professional challenges. This session
will focus on the application of justice in supporting the ethical delivery of interventions for
patients with obesity and related health issues.
Aims:

To consider ethical issues in relation to interventions aiming to promote public
health

To examine ethical and professional issues in providing healthcare for patients with
obesity and health behavioral challenges

To consider conceptions of justice and their application in addressing stigma and bias
towards patients with obesity
Objectives:
After the session, you will be able to:

Explain how stigma and bias may negatively affect healthcare professionals’ and
responsibility in caring for patients with obesity

Consider how conceptions of justice could be applied to ethically support and limit
interventions for obesity and related health issues at both individual patient and
public health levels
Speakers/Facilitators

A/Prof Lee See Muah, Adjunct Associate Professor and Senior Consultant, Ng Teng
Fong
General Hospital

Dr Voo Teck Chuan, Assistant Professor, Centre for Biomedical Ethics
Required Reading

Extracts from S. Holm, “Obesity intervention and Ethics”, Obesity Reviews 2007;8
(suppl. 1): 207-210.

Extracts from S. M. Fruh et al, “Obesity Stigma and Bias”, The Journal for Nurse
Practitioners 2016; 12(7): 425-432.
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Tutorial Presentation Case
The designated group to prepare its presentation on the following case scenario:
Ms. M is a 65 year old patient staying at a nursing home with morbid obesity (209kg, BMI
54.9) and multiple related health problems such as obesity hypoventilation and type 2
diabetes mellitus. She is admitted to a hospital for her 7th episode of respiratory failure
related to obesity hypoventilation syndrome (a breathing disorder that affects some people
diagnosed with obesity). Ms. M can no longer breathe effectively in this condition because
of obesity’s effect on the flow of air through the upper airways and the thorax, leading to
high carbon dioxide and low oxygen levels in the blood that can be life-threatening. These
episodes have been occurring over the past 2 years and are associated with bronchitis and
pneumonia. Ms. M has been poorly compliant with her dietary plans and her BiPap (a device
used for obesity hypoventilation syndrome) treatment. In the nursing home, on top of the
provided food, she regularly orders food delivery and unhealthy snacks from online services.
The medical team believes that Ms M. would likely succumb to a future episode of
respiratory failure unless she undergoes a strict medically supervised dietary programme
and/or bariatric surgical treatment. Ms. M refuses, which she has the autonomous right to
do as a person with decision-making capacity, and says that she prefers to diet and exercise
on her own to lose weight, even though she has been unable to do so for many years.
1. Explain the phenomenon of weight discrimination and how it may affect healthcare
professionals’ role and responsibility in obesity prevention and intervention.
2. Some hospital staff members do not feel comfortable with treating Ms. M again if
she were to be readmitted for another episode of respiratory failure related to
obesity hypoventilation. They feel that Ms. M’s nursing home should be told to send
her to another acute hospital in such an event. Reasons given to support this course
of action include B’s failure to take responsibility for his own health and the medical
team’s inability to convince B to go for the recommended treatment. Explain why
this action may not be a just or fair way to treat Ms. M.
3. Explain how the professional attributes of compassion and empathy may be applied
in the ethical management of Ms. M’s obesity and related health issues.
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4. Given her refusal to follow a strict diet plan and/or undergo surgical treatment, the
medical team considers alternative ways to help Ms. M reduce weight and prevent
obesity hypoventilation. One possibility is to get her nursing home to prevent
outside food delivery. Given Ms. M’s dire health circumstances, is this paternalistic
intervention ethically acceptable?
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Extracts from S. Holm, “Obesity intervention and Ethics”, Obesity Reviews 2007;8 (suppl.
1): 207-210.
Background
The purpose of ethical reflection is to help us decide how to act in the real world, all things
considered. Ethical reflection must take into account all aspects of a proposed course of
action. It must rely on good factual evidence and on an understanding of the social and legal
contexts in which action has to take place.
In the public health context, the main actors under consideration are, on the one hand, the
state and doctors and others in their roles as agents of the state, and, on the other hand,
the individual. The main principles or ethical values in play are respect for selfdetermination, the pursuit of a good life, the promotion of the common good, the
obligations between parents and children and justice.
The Basic Problems
Two basic ethical problems recur in discussions about obesity interventions. The first is
whether and when it is justifiable to intervene to promote a person's own health or wellbeing, if they do not want the intervention. When can paternalism be justified?
The second is whether and when it is justifiable to negatively affect a person or people's
well-being in order to benefit others or to promote the common good. In this context, it is
important to note that pure economic gain is usually not considered sufficient reason to
claim that the common good is being promoted.
These two problems do not occur on a neutral background. The current nutritional and
physical activity landscape is already shaped by numerous historical factors, by intentional
and unintentional effects of government regulation and by the actions of commercial actors.
The way society is organized is already affecting people's well-being in different ways.
...
Targeting High-Risk Groups
What are the ethical issues raised by interventions that target identified high-risk groups?
First, there are potential problems of social stigmatization and changed self-perception if
the targeting results in individuals being identified as belonging to a high-risk group. Insofar
as obesity is already a stigmatized condition, being identified as being at risk of obesity may
also amount to or produce stigma. This problem may be obviated to some degree if the
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targeting is performed by self-identification, but such a strategy will often lead to very
inefficient targeting.
Second, there are potential problems of justice. The reason for targeting high-risk groups is
usually cost-effectiveness. A given expenditure of resources will result in more obesity being
prevented than if we had chosen to employ a 'broader' strategy. But do individuals at similar
high risk, who are outside the identified high risk groups, not have the same claim on our
preventive resources? A basic principle of formal justice, originally outlined by Aristotle is
that equal cases should be treated equally, and this indicates that it is at least potentially
problematic to focus prevention only on high-risk groups, unless such groups can be so
precisely defined, identified and targeted that all high-risk individuals are included.
A different problem occurs in health promotions that target the whole population. In order
to achieve a reduction in the prevalence of obesity, it may be necessary to achieve
behaviour change far beyond simply the obese. It might be necessary to shift the whole
weight curve downwards (or shift the whole energy intake or physical activity curve). Thus,
all those who are overweight, or simply perceive themselves to be so, will have to change
their lifestyles in order to reduce the number of obese people. Many of those who are made
to feel concerned and are induced to change their lifestyle might never have become obese
or have had any significant health problems related to their weight. This means that we are
affecting some individuals negatively in order to benefit others or to create healthcare
savings at the societal level. This can be justified if the bad thing that is averted (obesity and
its health effects) clearly outweigh the negative effects experienced by the non-obese, but if
this is truly the case, it needs to be substantiated.
Choice and Responsibility
It is a commonplace that people are responsible for the foreseeable consequences of their
choices and actions. This seems to indicate that the obese are responsible for being obese
and for the health and other consequences of their obesity. There are, however, a number
of complications in making a claim of personal responsibility.
The first is that it is not clear to what degree lifestyle is actually a matter of conscious
choice. There are at least large elements of socialization and social construction involved in
acquiring and maintaining a given lifestyle, and the possibility to break with or significantly
alter one's lifestyle is significantly influenced by a range of socioeconomic factors.
The second is that the lifestyle in question may contribute significantly to the person's sense
of well-being. They may simply like to live the way they live and may accept future negative
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effects as a reasonable trade-off for their current pleasure and well-being. We may well
think that they have either miscalculated the trade-off over time, or that they could get the
same amount of well-being now by changing their lifestyle. But whether a given individual
will have a better quality of life as a burger-eating smoker or a vegetarian fitness enthusiast
is probably not a question that can be objectively decided by a third party.
The final problem is that, even if we could demonstrate that the obese had chosen to be
obese, and are therefore responsible for their own obesity and its consequences, that still
would not settle the question of whether we should hold them responsible and treat them
differently. Unless we treat all similar, non-obesity-related instances of negative health
effects of personal choice in the same way, the obese would have a strong claim that they
are being treated unjustly.
We should also note that there is an inherent tension between a focus on personal choice
and responsibility and the justification for large-scale interventions that affect some nonobese individuals negatively (e.g. by inducing unnecessary lifestyle changes). If the obese
are personally responsible for their condition, it becomes doubtful whether others should
sacrifice their interests to benefit the obese. For these reasons, it is ethically problematic to
pursue a policy primarily emphasizing choice and responsibility.
This raises further the question of whether it is a condition, in expecting personal
responsibility, that society does its part. Can we legitimately expect members of society to
show responsibility if society does not shoulder its responsibilities or is not perceived to be
shouldering its responsibilities? Is there a requirement of 'reciprocity of responsibility'? It
may, for instance, be argued that, if society could reduce obesity by prohibiting specific
marketing strategies, but declines to do so, it is hypocritical to put much emphasis on
personal responsibility.
Many arguments in the debate about obesity try to determine exactly who has
responsibility, but it is important to remember that it is not a zero-sum game. There is more
than enough responsibility to go round for all parties; the state, the food industry and the
individual. We have no reason to believe that only one of these parties is responsible, and
even less reason to believe that only one party should be held responsible.
EARLY-LIFE INTERVENTION
It is generally accepted that many instances of obesity can be traced to early childhood or
possibly even to the intrauterine environment. A potential, and on the face of it, very
attractive intervention strategy is therefore to aim for optimal nutrition in this period. This
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would probably involve both intensive dietary advice to all parents, more intensive
monitoring of weight and body shape of all children, and targeted intervention in families
where monitoring reveals problems. Such an intervention could be seen as an extension of
current antenatal and health visiting initiatives.
The main ethical arguments for the intervention would be that it has good consequences for
the child and for society, and that parents already have an ethical and legal obligation to
promote the 'best interests of the child' (in law the obligation is for the child's interests to
be paramount). A general problem with the 'best interests of the child' argument is that we
do and must allow parents to act against the best interests of the child, or to act on their
conception of the best interest in many contexts. We do not think it is wrong for young
parents to save for pensions, even if spending the money now on their child could benefit
the child. Furthermore, if there is more than one child in the family, it will sometimes be
impossible to promote the best interests of both children at the same time when these
interests are in conflict (5).
It is therefore unclear whether parents actually have a strong obligation to promote optimal
nutrition in their children, or just a strong obligation to promote 'good enough' nutrition.
Achieving optimal nutrition for the child would, in the prenatal period, physically require
that the mother changes her nutritional pattern, and may later require that the whole
family begins to eat differently to the way they did before they had the child. This may well
be beneficial for everyone, but it is not obvious that there's a strong obligation to do this.
The scepticism about obligation is reinforced by two further factors. First is the observation
that dietary advice is not constant and that it is not all based on good evidence. 'Optimal
nutrition' therefore actually means 'nutrition currently believed to be optimal'.
Second is the fact is that not all overweight children go on to become obese adults.
Targeting risk groups in childhood therefore also necessarily leads to some families being
the target of unnecessary interventions.
Promoting Body Image
Another set of questions arises in interventions aimed at promoting a specific body image or
range of body images (i) over the strength of the evidence base for promoting this specific
body image; (ii) over the possible side effects (e.g. an increase in anorexia or other eating
problems) and (iii) over the risk of stigmatization of those with body shapes deemed not
ideal.
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In one way, discussing possible future interventions in this area is strange because it is quite
obvious that our culture and many other cultures already promote a specific body image,
not through public health campaigns but through ordinary advertising (6). Based on our
experiences, we can justifiably claim that it is difficult to promote one body shape as good
without implying that other shapes are bad, and it is unclear whether it is possible to
prevent people from linking bad body shape to personal and moral badness. This is
particularly the case when obesity is already stigmatized.
Conclusions
It will be evident from the discussion so far, that two interlocking discussions underlie many
of the ethical controversies in the obesity intervention area.
The first is a discussion concerning the correct analysis of value. Are all values subjective or
personal, or are there objective values? Is health good for everyone whether or not they
value it, or is it only good for those who choose to pursue it? The second is a discussion
concerning the degree to which society or the state is justified in interfering in personal
choices, and the legitimacy of different kinds of interventions.
Although these two discussions are conceptually distinct, they are linked because it may be
easier to justify paternalistic intervention if there are truly objective values.
However, even if there are objective values, there are probably more than one (e.g. health is
not the only value). This means that there might be a conflict of values and that they will
have to be balanced or prioritized.
This means that policies involving hard paternalism [e.g. imposing of certain restrictions] will
always be difficult to justify. However, even the most ardent libertarians can support many
policies based on soft paternalism [e.g. providing information], especially policies where
choice is not curtailed, but choosing healthier options is made easier, for instance, by
making the healthy choice the default. Such policies could be labelled 'libertarian
paternalist' (7) and are unobjectionable as long as they are based on solid evidence that the
healthy choice is really the healthiest option.
All interventions have costs, both ethical and economic/opportunity costs, and it is only
when we have some evidence for their effectiveness that we get a handle on whether the
costs outweigh the benefits.
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Extracts from S. M. Fruh et al, “Obesity Stigma and Bias”, The Journal for Nurse
Practitioners 2016; 12(7): 425-432.
Overweight and obesity are escalating in epidemic proportions in the United States.
Individuals with overweight and obesity are often reluctant to seek medical help, not only
for weight reduction but also for any health issue because of perceived provider
discrimination. Providers who are biased against individuals with obesity can hinder our
nation’s effort to effectively fight the obesity epidemic. By addressing weight bias in the
provider setting, individuals affected by obesity may be more likely to engage in a
meaningful and productive discussion of weight. Providers need to be the go-to source for
obesity-focused information on new and emerging treatments.
Overweight and obesity are escalating in epidemic proportions in the United States.
Individuals with overweight and obesity are often reluctant to seek medical help, not only
for weight reduction but also for any health issue because of perceived provider
discrimination. Providers who are biased against individuals with obesity can hinder our
nation’s effort to effectively fight the obesity epidemic. By addressing weight bias in the
provider setting, individuals affected by obesity may be more likely to engage in a
meaningful and productive discussion of weight. Providers need to be the go-to source for
obesity-focused information on new and emerging treatments.
Providers who are biased against individuals with obesity can hinder our nation’s effort to
effectively fight the obesity epidemic. Bias against those with obesity appears to be socially
acceptable and is reinforced by the media. In order to effectively facilitate change in weight
bias, providers must identify and overcome their own implicit and explicit weight-based
biases. Providers are regarded as the go-to sources for obesity-focused information on new
and emerging treatments; they also have the responsibility to communicate to patients and
the public that obesity is a disease that needs to be addressed in a respectful and
compassionate manner. The purpose of this article is to raise awareness of health provider
weight bias and stigma and offer strategies that increase sensitivity and compassion to
individuals with obesity in an effort to provide the best possible health care.
Mass Media and the Perpetuation of Weight Bias
Mass media has stigmatized obese individuals. A review of research over the past 15 years
related to weight bias in media has reported that many media sources such as animated
cartoons, movies, situational comedies, books, weight loss programming, news coverage,
and YouTube videos have represented individuals who are overweight and obese in a
stigmatizing manner. Mass media has often promoted weight stigma as socially acceptable.
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A study that conducted a content analysis of news images found that the majority of images
presented portray obese individuals in a negative manner. The media commonly represents
individuals who are overweight and obese as headless figures who are inappropriately
clothed and eating. A recent study found that positive media images of individuals with
obesity had an affirmative impact on reducing weight-based stigmatizing perceptions held
by the public.
Health Care Provider Bias
Health providers need to be aware of the fact that most individuals who struggle with
overweight and obesity have often attempted many measures to lose weight. Obesity is
caused by many influences such as genetics and environmental factors. Lifestyle changes
can be especially difficult in certain environments. People with obesity often face ongoing
weight discrimination and bullying. Research has identified that obesity bias is prevalent in
health care settings. A recent study surveyed 358 nurse practitioners (NPs) at a national
conference regarding their attitudes and beliefs regarding individuals with obesity. The
study found that NPs reported negative beliefs and attitudes toward patients who are
overweight and obese. The participants of this study perceived individuals with overweight
or obesity to be not as good or successful as others, not fit for marriage, messy, and not as
healthy. A British study of 398 nurses found that only 2.3% had provided information to a
group related to an intervention for managing obesity. This study identified that very few
respondents indicated they had training in obesity management and reported they spent
5% of their clinical time in obesity management. This study also found that the nurses’ own
body mass index (BMI) was statistically related to their views of obesity; the higher the
nurses’ BMI, the lower their negative perception of obesity. A survey by Jay et al. with 250
physicians found that 40% reported a negative reaction toward a patient who was obese.
This study found that 56% of providers felt they were qualified to treat obesity, and 46% felt
they were successful in treating patients with obesity. The majority of the physicians
reported they felt frustrated when treating patients with obesity. A study with 255
physicians found that those who had a high percentage of patients with extreme obesity
were less likely to recommend weight loss medication or bariatric surgery to manage
weight. However, physicians with greater knowledge in obesity management were more
likely to treat patients with weight loss medications or bariatric surgery. This study also
identified that many physicians reported difficulty with performing physical examinations
such as palpating abdominal masses or completing pelvic and breast examinations because
of extreme obesity in patients. More than 50% of primary care physicians (n = 620) regarded
patients with obesity as “awkward, unattractive, ugly, and non-compliant.” The participants
did agree that if their time spent with obesity treatment was compensated properly they
would spend additional time on weight management. Research has found that primary care
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physicians (n = 122) spend less time with obese patients compared with thin patients
(mean= 31.13 minutes with normal-weight patients, mean = 25.00 minutes with patients
who were moderately overweight, and mean = 22.14 minutes with patients who were
extremely overweight). It is important for health providers to be knowledgeable about how
to provide care that is free of obesity bias and stigma. Extra care must be taken to prepare
providers to effectively perform a physical examination on individuals with obesity. Obesity
is one of the most prevalent diseases in America, and it is important that providers are
competent with all aspects of obesity treatment and management.
Patients’ Perception of Biased Care
Patients perceive obesity bias. Participants in a study were provided a list of 20 possible
sources of obesity bias and asked to rank them in order of frequency. Family members were
at the top of the list, and physicians were rated the second most common source of obesity
bias. This study did not observe a difference between sexes in relation to the forms or
frequency of obesity stigma that they experience. This study also identified that 53% of
women with obesity received inappropriate comments from physicians regarding their
weight. Younger women with obesity reported more stigma than individuals who were
older. Participants from this study also reported that they experienced weight stigma from
nurses (46%), dieticians (37%), and mental health professionals (21%). Eating more was
identified as a common coping strategy used to deal with obesity stigma. The majority (79%)
of the participants reported using this strategy on more than one occasion to cope;
however, 10% reported that they have not used this strategy for coping. Seventy-five
percent of participants reported refusal to diet as a coping style related to obesity stigma.
Weight Bias Impacts the Use of Health Care Services
Patients who experience obesity bias from providers may cancel or delay appointments as
well as avoid preventative health care and screenings. One study surveyed 498 women who
were overweight or obese regarding their perceived barriers to routine gynecologic cancer
screenings. The women were asked, “Has your weight been a barrier to getting appropriate
health care?” In response to this question, 52% responded yes. The percentage of women
who reported they delayed seeking health care increased as the BMI increased. These
women cited the following reasons for delaying treatment for care: providers expressed
negative attitudes, discourteous treatment, weighing procedures that caused
embarrassment, uninvited weight loss advice, and examining tables/gowns/equipment too
small to be functional. One study with 216 women found that delays and avoidance of
preventive care were associated with their BMI. The women participants in this study
reported that if they gained weight since their last office visit, they avoided making future
appointments with their health care provider. They also wanted to avoid being weighed on
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the provider’s office scale, knowing they would be told by their provider that they needed to
lose weight. Regardless of the reason individuals with overweight and obesity avoid
preventive health measures, weight bias and miscommunication between patients with
obesity and providers lead to a vicious cycle of bias and worsening obesity and health.
Obesity creates health consequences, resulting in an increased need for medical visits.
However, bias in health care can lead to negative feelings, avoidance of health care
providers, and unhealthy behaviors.
…
To reduce obesity bias, multiple strategies are needed. Providers can serve as a positive
influential voice to reduce obesity bias with their interaction and communication with the
public, peers, and students. Providers can also play a pivotal role in conveying that obesity is
a disease with a complex etiology. Providers can impart to the next generation of providers
the importance of eradicating obesity stigma and providing the best possible care to
individuals with obesity.
Resources and Strategies to Reduce Provider Obesity Bias
Many resources are available to help providers overcome obesity bias including free online
resources and online classes that address obesity bias and offer tips to help providers
reduce it. There are also specific supportive strategies to lower obesity bias that can be used
in the clinical setting.
How Can Weight Stigma Be Reduced?
Some specific strategies for health professionals are as follows (taken directly from the
Obesity Society):
1. Consider that patients may have had negative experiences with other health professionals
regarding their weight, and approach patients with sensitivity.
2. Recognize the complex etiology of obesity, and communicate this to colleagues and
patients to avoid stereotypes that obesity is attributable to personal willpower.
3. Explore all causes of presenting problems, not just weight.
4. Recognize that many patients have tried to lose weight repeatedly.
5. Emphasize behavior changes rather than just the number on the scale.
6. Offer concrete advice (eg, start an exercise program, eat at home, etc, rather than simply
saying, “You need to lose weight”).
7. Acknowledge the difficulty of lifestyle changes.
8. Recognize that small weight losses can result in significant health gains.
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9. Create a supportive health care environment with large, armless chairs in waiting rooms,
appropriately-sized medical equipment and patient gowns, and friendly patient reading
material.
How to Identify One’s Own Bias?
It is also useful to identify one’s own bias. Asking the following questions can be helpful in
this regard (taken directly from the Obesity Society):
1. Do I make assumptions based only on weight regarding a person’s character, intelligence,
professional success, health status, or lifestyle behaviors?
2. Am I comfortable working with people of all shapes and sizes?
3. Do I give appropriate feedback to encourage healthful behavior change?
4. Am I sensitive to the needs and concerns of obese individuals?
5. Do I treat the individual or only the condition?
Specific Strategies to Help Providers Overcome Obesity Bias
Self-reflection. Providers need to incorporate strategies to help individuals who struggle
with obesity by providing compassionate care that is free of bias. It is important that
providers take time for self-reflection to identify if one has any personal biases and how to
overcome these assumptions in order to provide the best possible care.
Supportive Communication and Language. It is important to use supportive communication
and language. Emphasize achievable behavior goals rather than weight. Steer away from
language that places blame. It is important for providers to choose their words wisely. The
least stigmatizing/blaming terms recommended are weight, unhealthy weight, and high
BMI. The most stigmatizing/blaming words are fat and morbidly obese. The most
motivating words are unhealthy weight and overweight. The least motivating words are fat,
morbidly obese, and chubby. It is recommended that before discussing weight with patients,
consider the following language in discussions about weight:
1. “Could we talk about your weight today?”
2. “How do you feel about your weight?”
3. “What words would you like to use when we talk about weight?”
People-first Language. For years, health care education has stressed the importance of not
labeling individuals based on their disease. However, in practice, this people-first principal
has not been applied to obesity. It is important to put people first and not to label them by
their disease. For example, it is not appropriate to identify an individual as obese but
instead identify the individual as having obesity. By labeling someone by their disease, it
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often dehumanizes the individual, which further contributes to weight bias. It is also
important for publications and scholarly writing to reflect people-first language.
Conclusion
[Healthcare providers] can make a difference with the obesity epidemic by overcoming any
personal obesity bias and discrimination. They can also lead the way by addressing obesity
bias in their interactions with the public, peers, and patients. They can strive to become
knowledgeable and comfortable with providing evidence-based obesity care that includes
the best possible strategies and treatments to help individuals achieve a healthy weight. The
education of current and future health care providers needs to focus on raising awareness
of attitudes and bias toward obesity as well as addressing the development of empathy for
the patients’ struggles and experiences. Most individuals with excess weight have tried
repeatedly to lose weight and many have had previous negative experiences with other
health providers regarding their weight. Because of these reasons, there are many
suggestions for creating a supportive environment for obese patients in medical settings.
Providers also need to be aware that bias exists so that educational activities can be
integrated into training programs, professional development activities, and media
campaigns to ensure all patients are treated with respect and dignity. This will help make
certain that individuals with obesity are comfortable and feel supported when seeking
medical care and will go a long way to foster a positive health care environment so that
providers can have the opportunity to guide patients in effective weight treatment and
management.
[Providers] are a vital force in health care in America. [They] can be change agents in the
area of obesity bias. They can also strive to be experts in obesity management and care.
Obesity is one of the most prevalent diseases in America and impacts many medical
conditions. [Providers] can lead the way in providing nonbiased, high-quality obesity
management, treatment, and care. [Provider] education needs to include formal
preparation related to eliminating obesity bias and preparing the next generation of
providers to excel in obesity management. Obesity prevention and intervention are public
health priorities to improve the overall health of our nation. Addressing and eliminating
weight bias and stigmatization are vital first steps to ensuring that patients receive quality
care and effective weight treatment and management. By becoming aware of one’s own
biases, developing empathy for the experience of patients, and working to address the
needs of patients with obesity, health care providers will make strides to make the US a
healthier nation.
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