Obesity conversations: Why weight stigma matters in clinical practice?

I'm Dr. Ximena Ramos-Salas, a public health and obesity stigma researcher based in Sweden. And in the next five minutes, I'm going to give you some important insights on the impact of weight stigma and how we can overcome it in clinical conversations. Let's get started.

Research shows that most of us hold biased beliefs and attitudes towards weight and body size, and that these attitudes and beliefs can impact the way that we interact with patients living with obesity. Perhaps the most common bias is the idea that obesity can be prevented and managed solely through individual health behaviors, such as healthy eating and regular exercise. But, as science has shown us, although our own individual health behaviors can contribute to weight gain or weight loss, there are many other factors beyond our control that impact our weight.

Research has also shown us that experiencing weight stigma can result in patients delaying or avoiding medical health services. But obesity is a chronic disease, and all patients living with chronic diseases have the right to access evidence-based and non-stigmatizing care. So what can we do? First, we can start by listening to patients during clinical consultations about why they're in the clinic and not assume that they're there to talk about their weight or that the health issue that they're presenting with is automatically linked to their body weight.

When patients feel that their health concerns are being dismissed or that healthcare providers may be judging them because of their weight, they may lose trust in those providers. That distrust can result in patients avoiding seeking medical help. Second, you can objectively assess your own unconscious beliefs and attitudes about weight and obesity and consider how these may be impacting your interactions with patients.

There are many self-assessments that you can do, such as the implicit association test. The point is to consider whether you are unconsciously treating patients living with obesity differently or unfairly compared to other patients, and if you're making assumptions about their presentations and how to treat them, and then focus on being objective and supportive. Third, we know that using biased and stigmatizing language can result in patients feeling defensive, ashamed, and self-conscious, leading them to wanting to exit the medical conversation.

This is why it's important to avoid unsolicited comments about body size and body weight changes, and that goes for gaining or losing weight. Always ask for permission to discuss weight if medically necessary and allow patients to lead the conversation if they're comfortable. If they're not comfortable or ready to talk about obesity, offer them resources about obesity as a chronic disease and an opportunity to have that conversation in the future.

The fourth strategy is to use neutral and nonjudgmental communications based on the science of weight and obesity. Remember, there is no such thing as an ideal body weight or even a healthy body weight that fits everyone. Obesity is defined as excess or dysfunctional body fat that impairs a person's health and well-being.

Finally, we can emphasize health and quality of life in all obesity clinical conversations, rather than just focusing on body size, weight, or weight loss. Remember, measures such as weight and body mass index are simple screening tools for obesity, and diagnosing obesity requires objective medical assessments. This also means that not all patients with a higher body mass index need to receive obesity treatments, and we should avoid encouraging weight loss unless it's medically necessary for improved health and quality of life.

Remember, the goal of any chronic disease treatment is to improve health and well-being. I'm Dr. Jimena Ramos-Salas for 5-Minute CPD. Thanks for watching.

Be sure to check out additional resources on this page and additional learning on the iaso.org website.