I enjoy speaking to healthcare professionals helping them identify efficient and effective approaches to patient-centered obesity care.
One of the most interesting questions I received recently from physicians is how to approach the topic of weight with patients when they themselves are not comfortable with their own weight – be it higher than they want or lower.
In very few clinical situations does the clinician’s appearance that includes one’s body size influence one’s dialogue with patients.
Studies have found that a healthcare professional’s own body mass index can influence their confidence, how often they bring up weight, and how patients perceive their advice.
This is a sensitive topic for both clinicians and patients with some key obesity care teaching points:
1-Weight Bias and Stigma Can Affect Both Patients and Clinicians
Attention to weight bias and stigma plays a central role in establishing a trusting and respectful clinician-patient relationship.
We know that patients can be shamed and blamed for their weight, especially in healthcare encounters.
Less talked about is that patients themselves can make assumptions about their treating clinicians, based on their body size, whether larger or smaller.
What I’ve heard from front-line physicians, is frustration when a patient requests a different provider because of the provider’s body weight.
Just like with other diseases, the complex disease of obesity can affect anyone – both patients and clinicians.
2-Weight Bias and Stigma Create Counseling Opportunities
Weight bias is so pervasive in our society and needs to be addressed at all levels of care.
A better understanding of this can pave the way for discussions about the disease of obesity.
Having overweight or obesity is not a personal choice or due to a lack of willpower.
Both providers and patients need to understand that one’s competency or skills are not tied to one’s body size.
Clinicians can reiterate that the healthcare professional’s primary role is to act as a partner in the patient’s health journey.
3-Empathy, Not Assumptions Improves the Clinician-Patient Relationship
Communication strategies to minimize weight bias include avoiding weight-based assumptions and stereotypes.
Though clinicians rarely interject their personal stories during the patient encounter, patient discussions during obesity care encounters may be an exception.
For clinicians with overweight or obesity, it offers an opportunity to express compassion and shared lived experiences. This honesty will likely improve trust and rapport.
For clinicians with a thinner body, it’s important to stress one does not have to harbor the disease to provide effective treatment.
Empathy and support can go a long way toward improving the delivery of patient-centered weight management care.
RK
Robert Kushner, MD
