2. Reducing weight bias in obesity management

Question 1

what does the terms weight bias, stigma and discrimination reflect?

Answer 1

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

Question 2

Explicit weight bias is defined as ?

Answer 2

having overtly negative attitudes toward people with obesity

Question 3

what are examples of explicit weight bias?

Answer 3

assumptions that people living with
obesity are lazy, unmotivated, lacking self-discipline or willpower
and noncompliant with medical treatment

Question 4

having unconscious negative attitudes toward people in large bodies - what is the term describing this?

Answer 4

implicit weight bias

Question 5

the extent to which
individuals living with obesity endorse negative weight-biased beliefs about themselves - what is the term for this?

Answer 5

internalized wt bias, or self-directed bias

Question 6

research has
shown strong associations between internalized weight bias and
which health outcomes?

Answer 6

mental

Question 7

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?

Answer 7

weight bias internalization has been associated with exercise avoidance and binge eating

Question 8

the manifestation of weight bias through harmful social stereotypes
that are associated with people living with obesity - what term is this?

Answer 8

weight stigma / obesity stigma

Question 9

An example of
weight or obesity stigma in the healthcare system is ?

Answer 9

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.

Question 10

what can lead to weight discrimination?

Answer 10

wt bias and stigma

Question 11

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?

Answer 11

40

Question 12

Weight/height discrimination has been found to have significantly
increased - The prevalence of weight discrimination has increased by how much over the past decade

Answer 12

66%

Question 13

What are the 3 types of consequences of weight bias, stigma and discrimination?

Answer 13

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

Question 14

Physical health consequences - what are the physiological mechanisms that may contribute to increased risk to physical health?

Answer 14

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

Question 15

One longitudinal study has also shown that perceiving weight discrimination is associated with a how much % increase in mortality risk

Answer 15

60;

Indeed, the effect of weight-based discrimination was comparable
to other established risk factors, such as smoking history and disease
burden

Question 16

adults who internalize weight
bias are more likely to …

Answer 16

adults who internalize weight
bias are more likely to binge eat

Question 17

Coping mechanisms for individuals who experience weight discrimination are to engage in unhealthy behaviours

Answer 17

T

Question 18

Weight discrimination also increases risk for obesity - T/F

Answer 18

T

Question 19

Psychosocial
correlates of weight bias include …

Answer 19

medication non-adherence, anxiety, perceived stress, antisocial behaviour, substance use, coping
strategies and social support

Question 20

In one study, the
harmful effects of stigma experiences extended beyond psychological distress and morbidity of obesity to include an increased risk in what?

Answer 20

all-cause mortality

Question 21

Depression is associated with weight gain and individuals with
obesity are at greater risk of depression, particularly those categorized with which class of obesity?

Answer 21

2 & 3

Question 22

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?

Answer 22

weight discrimination

Question 23

inequities in interpersonal
relationships and fewer opportunities for education and employment - what are these consequences from weight bias called?

Answer 23

social and economic consequences

Question 24

what is a fundamental driver of weight bias?

Answer 24

a lack of public
understanding of the complex and multi-faceted nature of obesity

Question 25

obesity is a self-inflicted choice and that it is only up to individuals with obesity to
address their own obesity - -T/F

Answer 25

F

Question 26

Public health
research has identified a need to:

Answer 26

• 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

Question 27

stigma has an independent impact on population …

Answer 27

health inequalities

Question 28

Ramos Salas
et al., identified five prevailing narratives that may contribute to
weight bias:

Answer 28

1. Childhood obesity threatens the health of future generations and must be prevented;
2. Obesity can be prevented solely through healthy eating and physical activity;
3. Obesity is an individual behaviour problem;
4. Achieving a healthy body weight should be a population health target; and
5. Obesity is risk factor for other chronic diseases and not a disease in itself.

Question 29

what are the Consequences to engagement in primary healthcare?

Answer 29

Weight bias in healthcare settings can reduce the quality of care
for patients living with obesity - may impact morbidity and mortality

Question 30

existing evidence suggests
that healthcare professionals may be spending inadequate time with patients with obesity - T/F

Answer 30

T

Question 31

How do we reduce weight bias, stigma and discrimination in healthcare settings?

Answer 31

be aware of their own attitudes and behaviours toward individuals living with obesity

Question 32

what is implicit association test for weight bias?

Answer 32

self-assessment tool for weight bias

Question 33

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?

Answer 33

sensitive questioning/dialogue/motivational
interviewing (e.g., “Can you share with me if or how your weight
affects your perception of yourself?)

Question 34

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?

Answer 34

coping strategies

Question 35

Reviews of weight bias reduction interventions have shown that
one approach is sufficient to reduce weight bias among health professionals - T/F

Answer 35

F

Question 36

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:

Answer 36

1. Present facts about uncontrollable and non-modifiable causes of
   obesity (i.e., genetics, biology, environment, socio-cultural influences
   and social determinants of health);
2. Provide positive contact with patients living with obesity to evoke empathy (i.e., include the patient voice);
3. Include empathic obesity experts as peer-modelling health professionals; and
4. Repeat exposure to patients living with obesity over the long term

Question 37

Promising strategies to reduce stigma in the healthcare setting include:

Answer 37

1. 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

3. Empowering patients to cope with stigmatizing situations and
   attain high-quality healthcare.

Question 38

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

Answer 38

T