In the News

Patients with obesity being stigmatised by professionals

Liz Blamire

11th August 2022

The Guardian are reporting on a systematic review by researchers at UCL in London that indicates that patients with obesity are being stigmatised.

Read: Obese patients ‘being weight-shamed by doctors and nurses’

The systematic review - Effective strategies in ending weight stigma in healthcare - looked at 25 interventional studies from the UK, USA, Canada, Australia and Germany, which aimed at reducing weight stigma in healthcare professionals. When individuals are stigmatised we know that this reduces motivation, discourages them from seeking help and can have significant psychological impacts. The ethical and health outcomes arguments for reducing weight bias in healthcare professionals is therefore very strong.

The researchers concluded by offering three recommendations for reducing weight bias in healthcare professionals:

First, there is a need to educate all healthcare students about the complex factors regulating body weight and address weight stigma, its prevalence, origins and impact, explicitly.

What does this mean and why is it needed? The researchers found that healthcare professionals form and develop their attitudes to overweight and obesity as students. A purely biomedical approach - measures of overweight and obesity and biological causes and risk factors - do not reduce stigma. What students need is to understand the complex social, cultural, environmental and genetic factors of overweight and obesity.

Second, there is a need to move away from a solely weight-centric approach to healthcare to a more health-focussed approach including weight-inclusivity.

What does this mean and why is it needed? Everyone has a human right to healthcare and healthcare should be made more accessible to people who are overweight and obese, for example by ensuring any necessary medical equipment is available in a spectrum of sizes. Similarly, healthcare professionals should be aware of and able to use interventions that improve patients' health regardless of their weight or weight change.

Finally, when conducting research on the relationship between weight, health and mortality, there is a need to ensure that researchers measure and account for the confounding and/or mediating effects of weight stigma.

What does this mean and why is it needed? A confounding variable is a factor other than the one being studied that is associated both with the disease (dependent variable) and with the factor being studied (independent variable), which can therefore distort the findings of research. The researchers argue that weight bias is both linked to the causes of obesity, as well as how we think and view obesity itself:

'Preliminary research shows that a significant proportion of the relationship between obesity and health outcomes can be explained not by body weight itself, but by the negative experiences commonly shared by people with overweight and obesity.'

Therefore, it is vital that in future research on obesity, weight stigma is considered a confounding factor.

What can student's of Health & Social care take from this?

This quote from The Guardian article is valuable for H&SC students to act on:

The language health professionals use with such patients is vital to building a rapport, getting them to engage in attempts to reduce their weight and avoiding them feeling blamed for it. “Using patient-first language when they refer to someone living with being overweight or obesity is the beginning. It is ‘a patient with obesity’, not ‘an obese patient’. It is ‘someone who is managing their weight’, not ‘struggling with their weight’. It is more than semantics.”

Liz Blamire

Liz is the current tutor2u subject lead for Health and Social Care. She is a former NHS midwife, who has worked in community, birth centre and acute hospital settings. Liz is an SSAT Accredited Lead Practitioner, who has taught Health and Social Care in FE and secondary schools, where she was a successful HOD. Liz is an experienced senior examiner and author.

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