Chapter 1 of 6 · Fundamentals
Introduction
Introduction: Passion, Patience, and Personal Experience in Obesity Care
Expert statements on this page
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Educational content from recorded physician discussions — not medical advice. Talk to your (or your child's) care team about your situation.
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What the experts said
Healthcare professionals cannot visually identify which children fall into high-risk BMI categories without actually obtaining and plotting BMI percentile.
Using guilt, shame, and blame to motivate individuals to make healthy changes is not supported by evidence and makes individuals less likely to make healthy changes.
For larger teenagers, it takes a long time to reach their current weight status and will take a long time to achieve weight reduction, requiring patience from providers.
A patient-centered, empowering approach utilizing motivational interviewing techniques can save time, improve clinical impact, and result in more pleasant provider encounters.
Clinical environments should have chairs that allow larger patients and parents to sit comfortably, as chairs with handrails may be too small for some families.
Examination tables should be rated for weights higher than 350 pounds to accommodate larger patients safely.
Weight scales should be placed in private areas rather than in open office spaces when dealing with the sensitive topic of weight.
Parents and children come to obesity clinic visits with high defensive walls due to previous experiences with weight bias, requiring creation of a safe environment before productive conversation can occur.
The American Academy of Pediatrics will be releasing a policy statement regarding weight bias in the next couple of years.
Parents often do not recognize when their child has obesity because weight gain happens gradually, and they may be very upset and emotional when given the diagnosis.
Weight bias has increased substantially over the last decade since 2006, with rates continuing to rise in more recent data.
Weight bias is more prevalent in women than men and increases with severity of obesity.
Children experience weight bias from peers, family members, school environments, and healthcare professionals.
Studies document that individuals affected by obesity experience differences in hiring preferences, promotions, wages, and early termination in the workplace.
Individuals endorsing more weight bias have higher levels of depression, anxiety, low self-esteem, and poor body image.
Weight bias leads to less preventative health services, fewer exams, more appointment cancellations, more delays in care, and less healthcare access.
Healthcare professionals are among the worst offenders of weight bias as experienced by patients, according to research studies.
Physicians view individuals challenged by weight as noncompliant, dishonest, lazy, lacking self-control, weak-willed, unintelligent, and unsuccessful.
In one study, 31% of nurses said they would prefer not to care for individuals affected by obesity and 24% said individuals with obesity repulse them.
Psychologists in controlled studies endorse that patients with obesity have more pathology, more severe symptoms, more negative family qualities, and worse prognosis on initial assessment.
