Bariatric Times

APR 2018

A peer-reviewed, evidence-based journal that promotes clinical development and metabolic insights in total bariatric patient care for the healthcare professional

Issue link: https://bariatrictimes.epubxp.com/i/958707

Contents of this Issue

Navigation

Page 15 of 28

Review 15 Bariatric Times • April 2018 weight bias awareness and from the opportunity to examine their own explicit and implicit attitudes. 68,69,74,78 Perspective-taking exercises might also help increase clinicians' empathy and positive affect among clinicians, improving attitudes and reducing stigma toward patients with obesity. 75-77,79–82 In addition to educational interventions, clinicians should work to alter the clinic environment to be less stigmatizing by providing chairs and medical equipment that accommodate patients of any size. 29,30 Furthermore, when providing obesity care, clinicians should focus on improved health and well- being, rather than solely on body weight. 59,65,66 CONCLUSION Obesity might make individuals vulnerable to unfair treatment and an impaired quality of care due to weight bias. Specifically, weight bias negatively impacts the attitudes, communication, and behaviors of healthcare professionals. These biases have been pervasive globally for several decades, affecting both practicing clinicians and medical students. Patients with obesity perceive the bias of healthcare professionals, and as a result, are less likely to experience continuity of care or pursue preventive services. This suggests patients with obesity might be receiving lower quality care and suffering from healthcare disparities. Given the prevalence of overweight and obesity, there is an urgent need to design and test interventions that minimize the effects of weight bias in the healthcare setting, particularly among practicing clinicians. Interventions among trainees that resulted in a sustained increase in empathy and decrease in stereotyping included education on the causes of obesity, increased awareness of weight bias and stigma, and enhanced perspectives on obesity treatments. Other interventions to consider include altering the clinic environment to be more weight- inclusive and changing counseling to promote improved health and well- being rather than focusing on weight. REFERENCES 1. Mosadeghrad AM. Factors influencing healthcare service quality. Int J Health Policy Manag. 2014;3(2):77–89. 2. Napoles-Springer AM, Santoyo J, Houston K, et al. Patients' perceptions of cultural factors affecting the quality of their medical encounters. Health Expect. 2005;8(1):4–17. 3. Naidu A. Factors affecting patient satisfaction and healthcare quality. Int J Health Care Qual Assur. 2009;22(4):366–81. 4. Kelley JM, Kraft-Todd G, Schapira L, et al. The influence of the patient-clinician relationship on healthcare outcomes: a systematic review and meta-analysis of randomized controlled trials. PLoS One. 2014;9(4):e94207. 5. Beach MC, Inui T, Relationship- Centered Care Research N. Relationship-centered care. A constructive reframing. J Gen Intern Med. 2006;21 Suppl 1:S3–8. 6. Beach MC, Roter DL, Wang NY, et al. Are physicians' attitudes of respect accurately perceived by patients and associated with more positive communication behaviors? Patient Educ Couns. 2006;62(3):347–54. 7. Johnson RL, Roter D, Powe NR, Cooper LA. Patient race/ethnicity and quality of patient-physician communication during medical visits. Am J Public Health. 2004;94(12):2084–90. 8. Cooper-Patrick L, Gallo JJ, Gonzales JJ, et al. Race, gender, and partnership in the patient- physician relationship. JAMA. 1999;282(6):583–9. 9. Thornton RL, Powe NR, Roter D, Cooper LA. Patient-physician social concordance, medical visit communication and patients' perceptions of health care quality. Patient Educ Couns. 2011;85(3):e201–8. 10. Beach MC, Rosner M, Cooper LA, et al. Can patient-centered attitudes reduce racial and ethnic disparities in care? Acad Med. 2007;82(2):193–8. 11. Gardner T, Refshauge K, Smith L, et al. Physiotherapists' beliefs and attitudes influence clinical practice in chronic low back pain: a systematic review of quantitative and qualitative studies. J Physiother. 2017;63(3):132–43. 12. Browne C, Kehoe M, Salmon N. How beliefs about bladder dysfunction among healthcare professionals influence clinical practice development: perspectives of allied health professionals, nurses, and managers. Int J MS Care. 2017;19(4):191–8. 13. Phelan SM, Burgess DJ, Yeazel MW, et al. Impact of weight bias and stigma on quality of care and outcomes for patients with obesity. Obes Rev. 2015;16(4):319–26. 14. Dovidio JF, Penner LA, Albrecht TL, et al. Disparities and distrust: the implications of psychological processes for understanding racial disparities in health and health care. Soc Sci Med. 2008;67(3):478–86. 15. Cooper LA, Roter DL, Carson KA, et al. The associations of clinicians' implicit attitudes about race with medical visit communication and patient ratings of interpersonal care. Am J Public Health. 2012;102(5):979–87. 16. Huizinga MM, Cooper LA, Bleich SN, et al. Physician respect for patients with obesity. J Gen Intern Med. 2009;24(11):1236–9. 17. Puhl R, Brownell KD. Bias, discrimination, and obesity. Obes Res. 2001;9(12):788–805. 18. Puhl RM, Heuer CA. The stigma of obesity: a review and update. Obesity (Silver Spring). 2009;17(5):941–64. 19. Puhl R, Wharton C, Heuer C. Weight bias among dietetics students: implications for treatment practices. J Am Diet Assoc. 2009;109(3):438–44. 20. Teachman BA, Brownell KD. Implicit anti-fat bias among health professionals: is anyone immune? Int J Obes Relat Metab Disord. 2001;25(10):1525–31. 21. Schwartz MB, Chambliss HO, Brownell KD, et al. Weight bias among health professionals specializing in obesity. Obes Res. 2003;11(9):1033–9. 22. Sabin JA, Marini M, Nosek BA. Implicit and explicit anti-fat bias among a large sample of medical doctors by BMI, race/ ethnicity and gender. PLoS One. 2012;7(11):e48448. 23. Tomiyama AJ, Finch LE, Belsky AC, et al. Weight bias in 2001 versus 2013: contradictory attitudes among obesity researchers and health professionals. Obesity (Silver Spring). 2015;23(1):46–53. 24. Flegal KM, Kruszon-Moran D, Carroll MD, et al. Trends in obesity among adults in the United States, 2005 to 2014. JAMA. 2016;315(21):2284–91. 25. Ogden CL, Carroll MD, Fryar CD, Flegal KM. Prevalence of obesity among adults and youth: United States, 2011-2014. NCHS Data Brief. 2015(219):1–8. 26. Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of childhood and adult obesity in the United States, 2011-2012. JAMA. 2014;311(8):806–14. 27. Maruthur NM, Bolen SD, Brancati FL, Clark JM. The association of obesity and cervical cancer screening: a systematic review and meta-analysis. Obesity (Silver Spring). 2009;17(2):375– 81. 28. Maruthur NM, Bolen S, Brancati FL, Clark JM. Obesity and mammography: a systematic review and meta-analysis. J Gen Intern Med. 2009;24(5):665–77. 29. Ferrante JM, Fyffe DC, Vega ML, et al. Family physicians' barriers to cancer screening in extremely obese patients. Obesity (Silver Spring). 2010;18(6):1153–9. 30. Amy NK, Aalborg A, Lyons P, Keranen L. Barriers to routine gynecological cancer screening for white and African-American obese women. Int J Obes (Lond). 2006;30(1):147–55. 31. Maruthur NM, Bolen S, Gudzune K, et al. Body mass index and colon cancer screening: a systematic review and meta-analysis. Cancer Epidemiol Biomarkers Prev. 2012;21(5):737–46. 32. Fischer R, Collet TH, Zeller A, et al. Obesity and overweight associated with lower rates of colorectal cancer screening in Switzerland. Eur J Cancer Prev. 2013;22(5):425–30. 33. Rosen AB, Schneider EC. Colorectal cancer screening disparities related to obesity and gender. J Gen Intern Med. 2004;19(4):332–8. 34. van Ryn M. Research on the provider contribution to race/ ethnicity disparities in medical care. Med Care. 2002;40(1 Suppl):I140–51. 35. Harvey EL, Hill AJ. Health professionals' views of overweight people and smokers. Int J Obes Relat Metab Disord. 2001;25(8):1253–61. 36. Thuan JF, Avignon A. Obesity management: attitudes and practices of French general practitioners in a region of France. Int J Obes (Lond). 2005;29(9):1100–6. 37. Campbell K, Engel H, Timperio A, et al. Obesity management: Australian general practitioners' attitudes and practices. Obes Res. 2000;8(6):459–66. 38. Fogelman Y, Vinker S, Lachter J, et al. Managing obesity: a survey of attitudes and practices among Israeli primary care physicians. Int J Obes Relat Metab Disord. 2002;26(10):1393–7. 39. Maddox GL, Liederman V. Overweight as a social disability with medical implications. J Med Educ. 1969;44(3):214–20. 40. Phelan SM, Dovidio JF, Puhl RM, et al. Implicit and explicit weight bias in a national sample of 4,732 medical students: the medical student CHANGES study. Obesity (Silver Spring). 2014;22(4):1201–8. Obesity might make individuals vulnerable to unfair treatment and an impaired quality of care due to weight bias.

Articles in this issue

Archives of this issue

view archives of Bariatric Times - APR 2018