EXPERT ANALYSIS FROM THE 2017 APA CONVENTION
WASHINGTON (FRONTLINE MEDICAL NEWS) – Stereotypical views held by physicians, psychologists, nurses, and other medical professionals about overweight and obese patients need to change, panelists said at the annual convention of the American Psychological Association.
“We have a lot of negative attitudes toward heavy-weight people. Judging patients as too big or too fat produces physical and mental health effects,” said Joan C. Chrisler, PhD , the Class of ’43 Professor of Psychology at Connecticut College, New London. “Shame and disrespectful treatment can lead to delay in seeking health care, reluctance to return visits, or lower trust in the providers and their recommendations.”
A study of more than 300 autopsy reports showed that obese patients were 1.65 times more likely than normal weight and underweight groups combined were to have medical conditions such as endocarditis, ischemic bowel disease, and lung cancer that were not diagnosed, Dr. Chrisler said in a press release ( Am J Clin Pathol. 2006 Jan;125[1]:127-31 ).
In addition to preventing patients from seeking care, Dr. Chrisler said in the release, unfamiliarity with the dosing adjustments sometimes required on medications based on the body mass index of patients affects the quality of care. She cited a retrospective study showing that emergency physicians frequently underdose common antibiotics in the emergency department ( Am J Emerg Med. 2012 Sep;30[7]:1212-4 ).
Maureen C. McHugh, PhD , stressed the importance of understanding the origins of fat shaming and its destructive effects.
“People aren’t born repulsed by fat people,” said Dr. McHugh, professor of psychology at Indiana University of Pennsylvania. “Fat hate is learned within the family.”
They encouraged more sensitivity from medical professionals when it comes to treating overweight and obese patients, such as providing changing gowns of different sizes in examination rooms and weighing patients in private areas of the medical office.
Dr. Chrisler and Dr. McHugh said weight stigma should be addressed in medicine and psychology through training and research, and in working with patients who are obese. “Treatments should focus on mental and physical health as the desired outcomes for therapy rather than weight,” Dr. McHugh said.
Dr. Chrisler, coauthor of a recent article on sizeism ( Fat Studies. 2017 Aug;6[1]:38-53 ), had no disclosures. Dr. McHugh also had no disclosures.
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