Weight Sensitivity
Training
Objectives
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Define obesity and stigma
Describe how weight stigma affects quality of
life
To increase awareness of weight bias among
health care professionals
To raise awareness and improve attitudes
among healthcare provider toward the obese
patient
Defining Obesity
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In general, when range of weight is greater than
what is considered healthy for a given height
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Identifies ranges of weight that increases likelihood
of certain diseases and health problems
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For adults, range determined by using weight & height
to calculate a number called the “body mass index”
(BMI)
BMI
BMI
BMI
BMI
BMI
18.5-24.9
25-29.9
30-34.9
35-39.9
>40
(NIH)
Normal Weight
Overweight
Obesity (Class 1)
Obesity (Class 2)
Obesity (Class 3)
What causes Obesity?
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Variety of factors
Eating too many calories
Not getting enough physical activity
Body weight is a result of:
Genes
Metabolism
Behavior
Environment
Culture
Socioeconomic status
Stigma of Obesity
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Definition of Stigma: Negative attitudes that
influence our interpersonal interactions
“Growing recognition of weight bias and stigma,
and its potential harmful consequences for obese
persons.”
Substantial evidence of obesity stigma in:
Employment
Education
Healthcare
(Puhl & Brownell, 2001)
Stereotypical Attributes of
Obese Person
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Lazy
Less competent
Sloppy
Less conscientious
“Think slower”
Poor self discipline
Emotionally unstable
(Puhl, RM, Brownell KD Bias, Discrimination, and Obesity 2001)
Obesity Attitudes in Health
Care
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Self-report studies show that Physicians,
Nurses, and medical students view obese
patients as:
Non-compliant
Dishonest
Lazy
Lacking in self-control
Weak-willed
Unsuccessful
Sloppy
(Paul & Townsend, 1995; Roehling, 1999)
It has been said obesity is
“the last socially acceptable form of
prejudice”
“Most obese patients have experienced a
lifetime of prejudice and discrimination”
(Murray, D. Morbid Obesity-psychological aspects and surgical interventions AORN
J 2003)
Utilization of Healthcare
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498 obese women surveyed:
Obese women delay preventive services
despite high access to care
Reasons:
Disrespectful treatment by providers
Embarrassment of being weighed
Negative attitudes by providers
Medical equipment too small
Receive unsolicited advice to lose weight
(Amy et al., 2006, International Journal of Obesity)
What can we do as Health Care
Providers?
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Consider that patients may have had negative
experiences with health professionals
Recognize that being overweight is a product of
many factors
Recognize that many patients have tried to lose
weight repeatedly
Emphasize behavioral changes rather than
weight
Acknowledge the difficulty of lifestyle change
Realize small weight losses can result in big
health gains
Create a Supportive Environment
(Rudd Center for Food Policy & Obesity Yale University)
Supportive Language
OLD
Overweight, obese
New
Person/Patient of size
Willpower
Commitment
Good/Bad
What works for you
Diet
Eating Style
Exercise Regimen
Activity Style/Physical activity
Expectations
Discoveries
Prescribe
Negotiate
Limit, restrict
Choice, experience
Ideal Weight
Healthy Weight
(Centers for Obesity Research and Education)
Create a Supportive Environment
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Treat patient with dignity and respect:
Direct eye contact
Good listening skill
Empathy
Avoid labeling patient: Big, hefty, plump, fat
Special equipment: Know weight limits & comfort
Avoiding labeling that indicates obesity to others
Know how to use bariatric equipment
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Utilize wider beds and furniture
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Have proper size BP cuffs & gowns
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Need easy doorway and bathroom access
Privacy
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Scales should be kept in a place where patients
can be weighed privately
Don’t make loud requests for extra large items
Don’t say: “I need a “Big Boy” bed”
Instead, say: “I would like to request a Bariatric
Wheelchair/Bariatric Bed”
Don’t say: All available lifting help to room 123
Instead, say: “All available help for transfer
report to Nurses’ station”
Weight Management Center
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Physician-monitored weight loss program
Program is combined with:
* Dietary and Nutritional
Counseling
* Behavior modification
New Weight Loss Surgery Program
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Dr. Julie Kim
Gastric Band Surgery: Uses an implantable device that
creates a bottleneck near top of stomach making it hard
to overeat.
-Adjustable & Reversible
Gastric Bypass Surgery: Reduces functional capacity of
the stomach changing the way food passes through the
stomach and intestines
-Used to treat severe obesity
Vertical Sleeve Gastrectomy: The stomach us divided
vertically and stapled removing more than 85% of the
stomach. The remaining stomach is shaped like a slim
banana and measures 1-5 ounces This surgery can be
stage 1 of a 2-staged Roux-en-Y
Summary
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Weight stigma is common in health care
settings
Obesity bias may decrease quality and use
of health care services for many individuals
Health professionals can make a difference
by becoming aware of their own biases,
developing empathy, and working to address
the needs and concerns of obese patients.
(Rudd Center for Food Policy & Obesity Yale University)
Weight Sensitivity Test
1. Weight discrimination is one of the few discriminations
that still exists and is accepted.
a. True
b. False
2. Self-report studies show that physicians, nurses and medical
students view obese patients as: (check all that apply)
a. Non-compliant
b. Dishonest
c. Lazy
d. Lacking in self-control
e. Unsuccessful
f. Sloppy
Weight Sensitivity Test
3. Reasons obese women delay preventive services despite
access to care include: (Check all that apply)
a. Disrespectful treatment by health providers
b. Embarrassment of being weighed
c. Negative attitudes by providers
d. Medical equipment too small
4. Size discrimination is evident in: (Check all that apply)
a. Employment
b. Education
c. Healthcare
Weight Sensitivity Training
5. How can we provide a supportive environment for
patients of size:
a. Treat patient with dignity and respect
b. Avoid labeling patient big or fat
c. Have proper sized BP cuffs and gowns
d. Know how to use bariatric equipment