May 10, 2023 – Health professionals should examine their very own biases about their patients’ weight, a number one group of experts said this week.
The American Association of Clinical Endocrinology provides recommendations for weight reduction Prejudice or negative beliefs about obesity and weight stigma, defined as thoughts and actions that discriminate against people based on their weight and size.
The statement also asks professionals to ask patients with obesity about internalized weight bias, which is when an individual has negative self-esteem due to their weight.
“The real message of the document is that we need to recognize bias in all forms, both as physicians and as patients, and also the stigma associated with it,” said Karl Nadolsky, DO, of Michigan State University College of Human Medicine and lead creator of the statement. “And for patients, internalized weight bias is a complication of obesity, but it also contributes to and drives the pathophysiology of obesity.”
Learn more: Join our webinar, The effects of weight prejudice
This recent document builds on earlier work by the American Association of Clinical Endocrinology in 2012. At the time, the group proposed considering obesity as a chronic disease quite than a cosmetic condition or lifestyle alternative. In 2013, the American Medical Association officially adopted the concept.
In 2017, the group coined a brand new term, “chronic obesity disease,” to encompass the health complications related to extra weight, akin to heart disease, sleep apnea and knee osteoarthritis. Weight loss is used alongside other treatments to handle these complications, and isn't a goal in itself.
“We're trying to move away from a weight-centered approach and focus more on a person's health in a very holistic sense. … So if someone has complications like type 2 diabetes, sleep apnea and knee arthritis, the outlook is worse and there's a more urgent need for intensive care therapy,” Nadolsky said.
There is hope that this approach, combined with the brand new document, will help reduce stigma and prejudice and improve health outcomes.
“We don't know yet, but we do know that internalized weight biases contribute to barriers to treatment and treatment success, which then creates a vicious cycle,” Nadolsky said.
The document also states that healthcare providers should consider the next five principles when coping with obesity and chronic obesity-related diseases:
- Ask in case you can speak about weight and the health effects of a chronic illness brought on by obesity.
- Assess health status and complications.
- ADVICE on treatment options based on the severity of the obesity-related chronic disease.
- AGREE to a treatment plan and weight reduction goals.
- SUPPORT the continuing strategy of weight management by reassessing goals and treatment options.
Ultimately, the document states: “Optimal outcomes for patients with ABCD [adiposity-based chronic disease] require interactions between empowered, informed patients who are enabled to collaborate with the health care team and a prepared health care system with professionals, procedures and infrastructure that provide full access to evidence-based care.”