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Scientists call for stigma education after study reveals strong 'weight bias'

Overweight and obese patients are often shamed over their weight by doctors and nurses due to unconscious biases, resulting in them often avoiding appointments, feeling depressed or anxious and being more likely to put on weight, a study has revealed.

The scientists have called on medical schools around the world to include weight-inclusive teaching in curriculums.

The British researchers said more education for medics was necessary related to “weight stigma” to avoid this spilling over into healthcare. Some 64% of adults are overweight or obese, and this figure could increase to 71% by 2040 if current trends continue, says Cancer Research UK, whose research found obese adults were on track to outnumber those of a healthy weight.

Educating healthcare workers over stigmatising these patients could help address the country’s obesity crisis, as negative biases over weight limit access to healthcare services and treatment, reports The Independent.

Obesity can increase the risk of developing many health conditions, including Type 2 diabetes, high blood pressure and different types of cancer.

University College London scientists looked at more than 3 000 research articles on the topic to identify strategies to tackle negative biases towards overweight and obese patients, and published their findings in Obesity Reviews.

Lead author Dr Anastasia Kalea said her team found “extensive evidence” of “strong weight bias” among healthcare staff, including doctors, nurses, psychologists and obesity specialists.

Health professionals frequently “believe patients are lazy, lack self-control, overindulge, are hostile, dishonest, have poor hygiene and do not follow guidance”.

“Sadly, healthcare, including general practice, is one of the most common settings for weight stigmatisation and this acts as a barrier to the services and treatments that can help people manage weight,” she said.

“A common misconception among medics and others, is that obesity is caused by factors within a person’s control, focusing on diet and exercise without recognition of, for instance, social and environmental determinants.” She added that it was clear more needed to be done to educate healthcare professionals and medical students on the complex range of factors regulating body weight, and to address weight stigma, explicitly emphasising its prevalence, origins, and impact.

Study details

Effective strategies in ending weight stigma in healthcare

Britta Talumaa, Adrian Brown, Rachel L. Batterham, Anastasia Z. Kalea

Published in Obesity Reviews on 7 August 2022

Weight stigma impacts negatively healthcare quality and hinders public health goals. The aim of this review was to identify strategies for minimising weight bias among healthcare professionals and explore future research directions. An electronic search was performed in PubMed, PsycINFO and Scopus (until June 2020). Studies on weight stigma reduction in healthcare students, trainees and professionals were assessed based on specific inclusion and exclusion criteria. A narrative synthesis was undertaken to analyse emerging themes. We identified five stigma reduction strategies in healthcare: (i) increased education, (ii) causal information and controllability, (iii) empathy evoking, (iv) weight-inclusive approach, and (v) mixed methodology. Weight stigma needs to be addressed early on and continuously throughout healthcare education and practice, by teaching the genetic and socioenvironmental determinants of weight, and explicitly discussing the sources, impact and implications of stigma. There is a need to move away from a solely weight-centric approach to healthcare to a health-focused weight-inclusive one. Assessing the effects of weight stigma in epidemiological research is equally important. The ethical argument and evidence base for the need to reduce weight stigma in healthcare and beyond is strong. Although evidence on long-term stigma reduction is emerging, precautionary action is needed.


Obesity Reviews article – Effective strategies in ending weight stigma in healthcare (Open access)


The Independent article – Obese patients ‘weight-shamed by doctors and nurses’ (Open access)


See more from MedicalBrief archives:


Risks of CVD and metabolic disorders higher for stigmatised obese


Obese COVID patients twice as likely to be admitted to ICU or die — Swedish cohort study


UK plan to ban surgery for smokers and the obese


UK obese refusing treatment may lose benefits




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