Destigmatizing Obesity to Improve Patient Care

Although obesity affects more than 40 % of the U.S. population, many medical professionals are not properly equipped to talk about weight with patients.

Obesity, which is a common and treatable condition, characterizes patients who have a body mass index of 30 or higher. According to the Centers for Disease Control, many factors contribute to the issue, including eating habits, exercise levels, sleep patterns, genetics, medications and social determinants of health. Obesity is also linked to conditions like heart disease, stroke, type 2 diabetes and certain cancers, which are among the leading causes of preventable, premature death. Furthermore, obesity rates are on the rise, with prevalence increasing from 30.5% in 1999/2000 to 41.9% in March of 2020.

There isn’t a simple formula to tackling obesity, yet many doctors still treat it with a blanket approach. In an article for PBS News Hour, Scott Butsch, MD, director of obesity medicine at the Cleveland Clinic’s Bariatric and Metabolic Institute, explains that the “eat less, move more” strategy doesn’t work for all patients. “There are many different forms of obesity, but we’re treating them like we’re giving the same chemotherapy to all kinds of cancer,” he says.

Dr. Butsch also points out that the stigma associated with the condition can hinder preventive screenings and thorough clinical exams. “You have these physicians or clinicians … relating everything to the patient’s obesity without investigation,” he says. “The stereotypes and misperceptions around this disease just bleed into clinical practice.”

Research also indicates that fear of stigmatization may cause patients with obesity to be more reluctant to seek care. “The fear of being stigmatized may prevent people living with obesity from accessing cancer screening services, which are vital to early diagnosis and favorable outcomes,” says University of Sunderland’s Yitka Graham in a United Press International article. For example, she explains, women with obesity are less likely to be screened for cervical cancer, and men who are overweight or obese are less likely to be screened for colon cancer.

Within the article, Kristen Sullivan, director of nutrition and physical activity at the American Cancer Society, says that weight bias is prevalent in healthcare, but there are ways clinicians and healthcare facilities can address this to make people with obesity more comfortable seeking care:

• Use person-first language, such as “a person with obesity” instead of “an obese person.”
• Equip waiting areas, restrooms and exams rooms with furniture that is suitable for patients of all sizes.
• Acknowledge obesity as a complex condition and avoid overly simplistic guidance such as “eat less, exercise more.”
• Prohibit derogatory jokes and degrading comments about patients.

For further guidance on caring for patients with obesity, see MLMIC’s Risk Management Tip “Safely Caring for Patients of Size in the Office Practice.”