2. Reducing weight bias in obesity management Flashcards
what does the terms weight bias, stigma and discrimination reflect?
a continuum, with weight bias describing the negative weight-related attitudes, beliefs, assumptions and judgments in society that are held about people living in large bodies
Explicit weight bias is defined as ?
having overtly negative attitudes toward people with obesity
what are examples of explicit weight bias?
assumptions that people living with
obesity are lazy, unmotivated, lacking self-discipline or willpower
and noncompliant with medical treatment
having unconscious negative attitudes toward people in large bodies - what is the term describing this?
implicit weight bias
the extent to which
individuals living with obesity endorse negative weight-biased beliefs about themselves - what is the term for this?
internalized wt bias, or self-directed bias
research has
shown strong associations between internalized weight bias and
which health outcomes?
mental
Internalized weight bias has been
shown to have a negative impact on outcomes that have conventionally been associated with the management of obesity. what are the examples?
weight bias internalization has been associated with exercise avoidance and binge eating
the manifestation of weight bias through harmful social stereotypes
that are associated with people living with obesity - what term is this?
weight stigma / obesity stigma
An example of
weight or obesity stigma in the healthcare system is ?
if health professionals believe that individuals with obesity are non-compliant
with medical advice or treatment, and hence assume that obesity
management strategies will not work.
what can lead to weight discrimination?
wt bias and stigma
Weight bias and stigma are pervasive in our society. Approximately
how many % of adults report a history of experiencing some form of weight
bias or stigma?
40
Weight/height discrimination has been found to have significantly
increased - The prevalence of weight discrimination has increased by how much over the past decade
66%
What are the 3 types of consequences of weight bias, stigma and discrimination?
several physical, psychological and psychosocial consequences -
affect a person’s physical and mental health, lead to avoidance
of preventive healthcare, hinder obesity management efforts and
increase overall morbidity and mortality
Physical health consequences - what are the physiological mechanisms that may contribute to increased risk to physical health?
increased chronic stress, which can increase cortisol levels, and oxidative stress independent of adiposity
level;
weight or obesity stigma was positively associated with obesity, diabetes risk,
cortisol level, oxidative stress level, C-reactive protein level, eating disturbances, depression, anxiety and body image dissatisfaction
One longitudinal study has also shown that perceiving weight discrimination is associated with a how much % increase in mortality risk
60;
Indeed, the effect of weight-based discrimination was comparable
to other established risk factors, such as smoking history and disease
burden
adults who internalize weight
bias are more likely to …
adults who internalize weight
bias are more likely to binge eat
Coping mechanisms for individuals who experience weight discrimination are to engage in unhealthy behaviours
T
Weight discrimination also increases risk for obesity - T/F
T
Psychosocial
correlates of weight bias include …
medication non-adherence, anxiety, perceived stress, antisocial behaviour, substance use, coping
strategies and social support
In one study, the
harmful effects of stigma experiences extended beyond psychological distress and morbidity of obesity to include an increased risk in what?
all-cause mortality
Depression is associated with weight gain and individuals with
obesity are at greater risk of depression, particularly those categorized with which class of obesity?
2 & 3
Depression is associated with weight gain and individuals with
obesity are at greater risk of depression, and what can be the explanation for this relationship?
weight discrimination
inequities in interpersonal
relationships and fewer opportunities for education and employment - what are these consequences from weight bias called?
social and economic consequences
what is a fundamental driver of weight bias?
a lack of public
understanding of the complex and multi-faceted nature of obesity
obesity is a self-inflicted choice and that it is only up to individuals with obesity to
address their own obesity - -T/F
F
Public health
research has identified a need to:
- Change the public health obesity narrative to align with current
scientific and medical understanding of obesity as a chronic
disease; and - Develop comprehensive obesity strategies that reflect patient
experiences, which may prevent further stigmatization of obesity
stigma has an independent impact on population …
health inequalities
Ramos Salas
et al., identified five prevailing narratives that may contribute to
weight bias:
- Childhood obesity threatens the health of future generations and must be prevented;
- Obesity can be prevented solely through healthy eating and physical activity;
- Obesity is an individual behaviour problem;
- Achieving a healthy body weight should be a population health target; and
- Obesity is risk factor for other chronic diseases and not a disease in itself.
what are the Consequences to engagement in primary healthcare?
Weight bias in healthcare settings can reduce the quality of care
for patients living with obesity - may impact morbidity and mortality
existing evidence suggests
that healthcare professionals may be spending inadequate time with patients with obesity - T/F
T
How do we reduce weight bias, stigma and discrimination in healthcare settings?
be aware of their own attitudes and behaviours toward individuals living with obesity
what is implicit association test for weight bias?
self-assessment tool for weight bias
Because internalized weight bias can have negative impacts on
health-related outcomes, it is also important that health professionals assess their patients for internalized weight bias. how can this be accomplished?
sensitive questioning/dialogue/motivational
interviewing (e.g., “Can you share with me if or how your weight
affects your perception of yourself?)
what strategies to address
internalized weight bias should be incorporated into behavioural interventions, consistent with the principles of cognitive behavioural
therapy and acceptance and commitment therapy?
coping strategies
Reviews of weight bias reduction interventions have shown that
one approach is sufficient to reduce weight bias among health professionals - T/F
F
A systematic review of 17
weight bias reduction interventions among health student trainees and
practicing health professionals identified four key components to help
decrease weight bias among health professionals:
- Present facts about uncontrollable and non-modifiable causes of
obesity (i.e., genetics, biology, environment, socio-cultural influences
and social determinants of health); - Provide positive contact with patients living with obesity to evoke empathy (i.e., include the patient voice);
- Include empathic obesity experts as peer-modelling health professionals; and
- Repeat exposure to patients living with obesity over the long term
Promising strategies to reduce stigma in the healthcare setting include:
- Improving provider attitudes about patients with obesity and/or
reducing the likelihood that negative attitudes influence provider behaviour;
2.Altering the clinic environment or procedures to create a setting
where patients with obesity feel accepted and less threatened;
and
- Empowering patients to cope with stigmatizing situations and
attain high-quality healthcare.
Try focusing on improving healthy habits and quality
of life rather than weight loss. Weight is not a behaviour
and should not be a target for behaviour change - T/F
T
