CONTENT WARNING: This article discusses the topics of weight, weight loss, and body image.
From the TV shows we watch to the comment section of any plus-sized celebrity’s Instagram, fatphobia and weight bias are everywhere.
According to the Australian Institute of Health and Welfare, over two-thirds (67 per cent) of Aussie adults are overweight or obese – yet the war on larger bodies still exists.
Most worrying might be when weight bias finds its way into our healthcare system. A recent study published in eClinicalMedicine found Australian healthcare students had “alarming” rates of dislike towards those living with overweight or obesity, with the potential to negatively impact the care received.
Woman’s Day chats to endocrinologist and Juniper spokesperson Dr Ramy Bishay (myjuniper.com), to get an understanding of how weight bias presents itself in healthcare and what can be done…
WHAT IS WEIGHT BIAS?
First things first, though people in smaller bodies can face weight bias, those in larger bodies are more likely to experience it.
“Weight bias is when people have certain ideas about what people with obesity think, how they behave and live,” says Dr Bishay. “Weight stigma is when bias is ‘full blown’ and leads to discrimination that is targeted towards people with obesity.”
Both weight stigma and weight bias can have damaging long-term health impacts for those on the receiving end, including body dissatisfaction, low self-esteem, depression and other psychological disorders.
HOW DOES IT IMPACT HEALTHCARE?
In a 2016 US study, around 53 per cent of women with obesity reported hearing inappropriate comments from healthcare professionals about their weight when seeking care.
Such bias can make a provider less compassionate and cause them to attribute problems such as period pain and infertility to their patient’s body mass index (BMI) instead of an underlying illness.
And, as research by Juniper found, fear of misdiagnosis and judgement deters 79 per cent of women from seeking medical treatment for issues related to not only their weight, but everything else.
“This may be that they’re concerned the healthcare worker may bring up weight at the consultation, even though other research suggests many patients actually want their doctors to bring up weight at a medical visit,” Dr Bishay says.
He notes that much of this comes from the fact that some providers still perceive obesity or being overweight as a “lifestyle issue” rather than a physiologically driven condition.
WHAT DOES IT LOOK LIKE?
According to Dr Bishay, weight bias in healthcare takes many forms – the first being “passive weight bias”.
“One way it can manifest is when you hear doctors and nurses give simple, piecemeal advice on weight loss to patients that sounds like ‘eat less, move more,'” Dr Bishay says. “The belief here is that the solution is easy and that patients just don’t have the volition to take up the fight.”
This is based on the ill-founded idea that people who are overweight or obese are lazy or undisciplined. While more direct forms of weight bias can include rude remarks or jokes, Dr Bishay says practitioners aren’t the sole perpetrators of weight bias in healthcare.
“Inappropriate beds or chairs being unsuitable for patients, and even blood pressure cuffs or scales not being adequate to weigh patients are examples of a clinical environment that promotes weight bias and stigma,” Dr Bishay says.
ARE YOU EXPERIENCING WEIGHT BIAS?
If you’re on the receiving end of weight bias, it can be easy to want to avoid the doctor’s office. However, Dr Bishay says you should not give up on your health.
“I would start with a candid conversation with their doctor about seeking treatment,” he notes.
If needed, seek out a Health at Every Size (HAES) practitioner to ensure you receive care that considers all aspects of your health. If you want treatment for weight loss and are afraid of judgement, head to the Australian and New Zealand Obesity Society (ANZOS) website or get a referral from your GP to see someone who specialises in weight loss management.