May 10, 2023 – A leading group of experts said this week that healthcare professionals should check their biases about their patients’ weight.
The American Association of Clinical Endocrinologists makes recommendations aimed at losing weight Prejudice, or negative thoughts about being overweight, as well as weight stigma, which is defined as discriminatory thoughts and actions toward people because of their weight and size.
The statement also asked specialists to survey obese patients about internalized weight bias, or when a person feels negatively about themselves because of their weight.
“The real message from the document is that we must acknowledge bias in all its forms, as clinicians and patients, and then the stigma that comes with it,” said Carl Nadolsky, of Michigan State University’s College of Human Medicine. The author of the statement. “For patients, an internalized weight bias is a complication of obesity, but it also contributes to part of the pathophysiology of obesity.”
This new document complements previous work of the American Association of Clinical Endocrinologists dating back to 2012, when the group proposed considering obesity as a chronic disease, rather than a cosmetic condition or lifestyle choice. In 2013, the American Medical Association officially adopted this idea as well.
In 2017, the group created a new term, “obesity-based chronic disease,” to combine health complications associated with excess weight, such as heart disease, sleep apnea, and knee osteoarthritis. So weight loss is used among other treatments to treat these complications and not as an end in itself.
“We’re trying to move away from a weight-focused approach and focus more on a person’s health in a very holistic way. So if someone has complications like type 2 diabetes, sleep apnea, knee osteoarthritis, their results are Worse and more urgent need for intensive medical treatment.
The hope is that this approach, along with the new document, will help reduce stigma and bias and improve health outcomes.
“We don’t know that yet, but we do know that internal weight bias contributes to barriers to treatment and treatment success, which is a vicious cycle,” Nadolski said.
The document also said healthcare providers should follow the “5A” for obesity and obesity-based chronic diseases:
- Ask if you can discuss weight and the health impact of obesity-related chronic diseases.
- Assessment of health status and complications.
- Advise on treatment options based on the severity of obesity-based chronic disease.
- Agree on a treatment plan and weight-loss goals.
- Assist in the ongoing process of weight management with reassessment of goals and treatment options.
Ultimately, the document says, “Optimal outcomes for patients with ABCD [adiposity-based chronic disease] It entails interactions between empowered, informed patients who are energized to engage with the healthcare team, and a health care system equipped with professionals, procedures, and infrastructure that provides full access to evidence-based care.”