Consequences of Weight Stigma in Healthcare: Ted Kyle, RPh, MBA

BEDA promotes cultural acceptance of, and respect for, the natural diversity of sizes, as well as promoting a goal of improved health, which may or may not include weight change.  The views expressed by our featured bloggers are their own.

Ted Kyle

Ted Kyle, RPh, MBA, is a pharmacist experienced in collaborating with leading health and obesity experts for sound policy and innovation to address the obesity epidemic in North America. Ted is also an accomplished healthcare marketing and innovation professional and is also Vice-chairman of the OAC National Board of Directors.

In 2009, Ted founded ConscienHealth to help experts and organizations work for evidence-based approaches to health and obesity. Ted devotes much of his work to nonprofit advocacy, chairing The Obesity Society’s (TOS) Advocacy Committee, serving on the Steering Committee for the STOP Obesity Alliance, and serving on the National Board of Directors for the Obesity Action Coalition (OAC). At their respective annual meetings in 2012, both OAC and TOS presented Ted with their top awards for public service and advocacy. 

Ted completed a 26-year career with GlaxoSmithKline in 2008. Ted holds two degrees from the University of North Carolina at Chapel Hill: a BS in Pharmacy and an MBA. 

You can read daily updates from on health and obesity from Ted at http://conscienhealth.org/category/news/.

 

Weight Bias in Healthcare

Weight bias in healthcare is a serious and well-documented problem that makes obesity worse. Researchers have found physicians, nurses, dietitians, psychologists, fitness professionals and medical students harbor negative attitudes toward people with obesity. Even healthcare professionals specializing in the treatment of obesity have been found to have such attitudes.

The good news is that as professionals become more and more aware of the importance of treating obesity and the harm of weight stigma, many are taking steps to assure that they and their colleagues provide respectful care and support for people with obesity.

These negative attitudes have important negative consequences. When a patient feels disrespected, studies have shown that they are likely to postpone needed healthcare, leading to further complications from obesity. Perhaps this explains a recent finding that experiencing weight discrimination more than doubled a person’s risk for developing obesity if they didn’t already have it. And for people with obesity, weight discrimination tripled the risk that they would still have obesity four years later, compared to those who experienced no discrimination.

When a recent study prompted broad attention to the fact that doctors treat slender patients with more respect, comments flooded discussion forums that brought this finding to life. Said one reader of the New York Times:

Two years ago I lost 140 pounds, and through that process I have been both disgusted and amazed with how differently the world, including medical professionals, treats me. When I was morbidly obese, I felt very harshly judged by doctors, and I often would stop going to doctors who I felt treated me inappropriately because of my weight. Yes, I expected my doctors to discuss my weight, but there are ways to do it that, create empathy. Now that my BMI is 21, the weight is a non-issue, whereas before it was pretty much all we talked about.

Another reader was more blunt:

You could walk in with an ax sticking out of your head and they would tell you your head hurt because you’re fat.

Anyone with a chronic condition feels vulnerable and deserves respect from their healthcare providers. Delivering it is a mark of professionalism. But too many healthcare providers feel a duty to deliver admonition to a patient with obesity to “take responsibility” for their obesity. A cancer surgeon summed up this point of view in commenting on this same study:

Obesity is a CHOICE. I don’t care what Oprah, Suzanne Summers and Tom Cruise say – it is a choice. Genetic obesity is probably true in about 5 percent of patients. I am not talking about people that are 10, 20 or 30 pounds overweight. But people that are 100’s of pounds overweight didn’t get that way because mother nature made them but because their OWN mother fed them poorly or they chose not to eat a healthy diet. Between 20 pounds overweight and 80 pounds overweight was 60 pounds of fast food, french fries and burgers. Nobody force fed these people a bad diet.

Issues of discrimination faced by people with obesity go beyond disrespect from providers. In the last decade, healthcare facilities have begun to recognize the need make their facilities accessible for larger patients. Approximately a third of U.S. hospitals invested in renovations in the past year to accommodate patients with obesity, according to Novation LLC, a hospital supply company that publishes an annual report on the cost of bariatric care.

The need is clear. Before one hospital made the investment, they turned away three to four patients weekly who were too big for their MRI, recommending they go to a veterinary facility. “That’s a hard conversation to have with somebody,” said the hospital’s MRI imaging team leader.

Obesity is a serious chronic disease which leads people to need and seek medical care. Respect and encouragement to muster a resolve for living in good health are essential. Blame and barriers to medical care are intolerable.

If you are a person with obesity who experiences disrespect from a healthcare provider, respectfully seek care from another provider who can give you the care and encouragement you deserve.

If you are a provider, consider the following factors to ensure you are giving patients the care and respect they deserve:

  1. Training to recognize and combat biases. Everyone harbors some bias. Medical training and objectivity can equip professionals to set their own biases aside. Failure to do so can seriously compromise patient care and must be addressed.
  2. Facilities and equipment that can accommodate patients with obesity. Facilities that miss this important consideration send a powerful message that one-third or more of their clients are not welcomed or respected.
  3. Remembering the patient is a customer. Provider bias against patients with obesity can create a negative atmosphere and hurt patient satisfaction. Professionals need to create a culture of respect to establish truly patient-centered care and strengthen their engagement with patients.
  4. Resources from the Obesity Action Coalition. A guide to bias in healthcare may be found at  http://www.obesityaction.org/weight-bias-and-stigma/weight-bias-guides/weight-bias-in-healthcare-a-guide-for-healthcare-providers-working-with-individuals-affected-by-obesity.