Name: The Impacts of Weight Bias in Healthcare（The Impacts of Weight Bias in Healthcare）
Uploaded: 2023-04-04T18:55:24.000Z
Duration: 10 min 8 s
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"The Impacts of Weight Bias in Healthcare"

Although total fasting can dramatically increase blood levels

of the stress hormone cortisol, as much as

doubling within five days, just dieting alone does not.

There is, however, a way stress and obesity could

turn into a vicious cycle: weight stigma.

Across thousands of individuals followed for four years,

those reporting discriminatory experiences

had more than twice the odds of becoming obese.

And those who started out obese had more than three times the odds

of staying that way compared to those who started out

at the same weight but didn't experience discrimination.

Now, this could be from stress-induced eating

on one side of the calorie balance equation

or stigma-induced exercise avoidance on the other.

Obese individuals with more frequent experiences with

weight stigma report greater avoidance of exercising in public,

These “too fat to exercise” fears may be well-grounded.

Strong anti-fat biases have been documented in both

fitness professionals and regular gym-goers, which may translate

into an unwelcoming environment in fitness centers and health clubs.

Whichever side of the calorie equation gets tipped,

those who experience weight stigma can also end up suffering

health consequences independent of any added weight.

Those reporting more frequent fat prejudice exhibit higher levels

of depression, higher levels of inflammation, and higher levels

of oxidative stress, as well as a shorter lifespan.

Two studies following a total of nearly 20,000 people

both found about a 50 percent increase in mortality risk

among those reporting greater daily discrimination.

Weight discrimination may shorten life expectancy.

Despite these hazards, some scholars advocate

The President Emeritus of the prestigious Hastings Center

infamously advocated for “a kind of stigmatization lite,”

using social pressures to compel people to lose weight

without resorting to outright discrimination.

After all, he argued, what else has the potential to counter

the persuasive force of the billions spent in advertising

every year by the food and beverage industry.

He recalls his own battle with addiction:

“The force of being shamed and beat upon socially was as

persuasive for me to stop smoking as the threats to my health.”

The public health campaign to stigmatize cigarettes turned

“what had been considered simply a bad habit

When such campaigns have been tried, they have been met

Georgia's Strong4Life campaign featured billboards of

morose-looking obese children with captions like

“Warning: Chubby kids may not outlive their parents” or

“It's hard to be a little girl when you're not.”

The campaign sponsors defended the ads as an attempt

to break through the denial in a state with some of the

highest recorded childhood obesity rates.

It's only defensible, though, if it works.

Yale researchers found that when normal-weight women

provided with bowls of M&M's, jelly beans, and chips

to snack on after watching clips of stigmatizing material

like clumsy, loud, lazy stereotypes getting teased

about their weight, they eat about the same amount

compared to watching neutral material such as insurance commercials.

But when overweight women watch the same two sets of videos,

The researchers concluded, “This directly challenges the notion

that pressure to lose weight in the form of weight stigma will have

a positive, motivating effect on overweight individuals.”

In other words, it could make things worse.

Being labeled “too fat” in childhood was associated with a

higher risk of becoming obese compared to children

weighing the same who were never told that.

But does that mean we should just ignore the elephant in the room?

Just as veterinarians have been found to be reluctant

fewer than a quarter of parents of overweight children report

having been told by pediatricians about their child's weight status.

but a Gallup Survey found that parents appear to be

“notoriously poor judges of their children's weight.”

Similarly, the percentage of adults who describe themselves

as overweight has remained essentially unchanged

over the past few decades, despite skyrocketing obesity.

All this, Gallup concluded, helps “paint a picture of

mass delusion in the United States about its rising weight.”

I think patients have the right to be informed.

Those told by their doctor that they are overweight

have about four times the odds of attempting weight loss

Just as smoking physicians are less likely to challenge

their smoking patients, overweight physicians are less likely

or even document obesity in their charts.

Ironically, overweight patients trust diet advice

from overweight doctors more than docs who are normal weight.

Unfortunately, primary care physicians appear

to have little to offer in terms of specifics.

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The Impacts of Weight Bias in Healthcare（The Impacts of Weight Bias in Healthcare）

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