Doctors and nurses' weight biases harm overweight patients

  1. 0 Here is a link to the L.A. Times Article:

    Doctors and nurses' weight biases harm overweight patients - latimes.com

    I was interested in what nurses they interviewed. While I know nurses have patients they'd rather not deal with (though they will anyways), to say you wouldn't even want to touch someone just seems like a bad idea and is asking for someone to sue.

    Any experiences with nurses that share this view?
  2. Visit  lrobinson5 profile page

    About lrobinson5

    From 'Riverside, CA'; 25 Years Old; Joined Oct '09; Posts: 758; Likes: 1,054.

    28 Comments so far...

  3. Visit  HappyBunnyNurse profile page
    26
    Having read some past threads on here I can't say I'm surprised. There was a discussion a few weeks ago where an obese patient was referred to as "slothful" and "gluttonous". I said it then and I'll say it now....... anorexic people who weigh 80 pounds are seen as sick patients who need help but morbidity obese patients who weigh 500 pounds are seen as noncompliant people who just lack willpower. Obviously both type of patient have an EATING DISORDER and need physical and psychiatric intervention. But how easy is it to ask for help if your health care provider doesn't even want to touch you?
    Skips, Angie O'Plasty, RN, tvccrn, and 23 others like this.
  4. Visit  Esme12 profile page
    19
    As a person who was "slightly" overweight and just needed to lose a few pounds to someone who hs gained ALOT of weight with the daily ingestion of high dose steroids...........I definately treated differently now.......I am treated with distain and comtempt.........It's very sad. So now I am not only sick and cannot walk.......people talk down to me and treat me like I cannot understand the spoken word because I am fat. If I wasn't depressed before because of the ravages of my disease........I sure am because of the poor,impolite and rude behaviors of others who feel obligated to vent their opinion on anyone they feel is inferior to them or somehow lacking.......very sad for them.......Frankly I try to ignore them
    Last edit by Esme12 on Dec 15, '10
  5. Visit  fludddwrn profile page
    8
    I am a healthcare provider and I am also considered obese. I do not feel bad about myself and do not consider my obesity related to any disorder. I gained a alot of weight over the past 10 years and I need to lose the extra pounds if I want to maintain my health. MY HEALTH is my responsiblity. Too often we give people excuses not to try to do what is right. Now if someone said to me you are obese I would try to lose weight. I might not be successful but I will try. But often when I say that to patient they are offended. I tell them what they should do to lose weight. We as Americans make to many excuses to do whatever we want. It is not the anyone fault if you are overweight or obese but your own. When we all became RESPONSIBLE. WE WILL HAVE A HEALTHY COUNTRY
  6. Visit  jcgrund profile page
    10
    That is very sad. Although I don't consciously feel negativity toward overweight individuals, this discussion gives me pause to consider if I may act differently with obese patients subconsciously. Being an average size without really trying, I consider myself lucky that I don't have a problem with weight. If I did, I would hope that the people caring for me would treat me with the same respect a thin person would get. In the future I will be more mindful of how I may subconsciously treat overweight people. I truly believe all people deserve respect and compassion no matter the circumstances.
    tvccrn, mustlovepoodles, wooh, and 7 others like this.
  7. Visit  lrobinson5 profile page
    3
    From the article:

    "Some healthcare professionals actually believe that stigma and shame can be used to help motivate patients to lose weight."

    "My siblings just wanted to torture me-and that they did. But they, unlike doctors and nurses, weren't under any sort of ethical or professional mandate to be kind."

    Are there really a majority of doctors that believe mentally abusing someone will motivate them into weight loss?

    And do you, as a nurse, feel that you have 'an ethical or professional mandate to be kind'?

    Weight is such a sensitive subject for women, what would be the best way to address their health issues without hurting their feelings? Or is it just simply the truth hurts?
    talaxandra, Quark09, and Esme12 like this.
  8. Visit  kythe profile page
    24
    Quote from lrobinson5
    From the article:
    And do you, as a nurse, feel that you have 'an ethical or professional mandate to be kind'?

    Weight is such a sensitive subject for women, what would be the best way to address their health issues without hurting their feelings? Or is it just simply the truth hurts?
    I once worked in a family practice office where this issue came up. The doctor was a very slender woman, but she did seem very sensitive toward her patients who were obese. We once had a family come in that were all too large to sit in the chairs with armrests. I was trying to room the patient and was suddenly embarrassed to realize the problem, so I had the patient sit on the exam table to get her vitals and then told the doctor.

    She spoke spoke with the patient for some time and referred her to a specialized weight-loss clinic. She found the woman very receptive to help with her weight, but was concerned that it needed to be approached in a way that the woman did not feel any loss of dignity. Then she had more chairs ordered for the office that were larger and did not have armrests so that in the future, patients and family of larger size would feel comfortable in the office. If people are not treated well, they aren't motivated to become healthier, they just feel rejected by the medical community and are less likely to seek help in the future.
    finn55, HappydayRn, leslie :-D, and 21 others like this.
  9. Visit  VickyRN profile page
    2
    My College of Nursing has pioneered research in bariatric nursing and the barriers and challenges that this special patient population presents to receiving safe, effective care (for both the patient and the nursing staff).
    Elvish and Quark09 like this.
  10. Visit  merlee profile page
    4
    I've been the recipient of painful remarks by health-care pros who didn't even know me. In one year I gained nearly 60 lbs due to steroids taken for extremely bad asthma problems. Sixty pounds! I was 39, and trying to get pregnant. A partner at the OB clinic told me to lose weight first in a voice that dripped with disdain. I cried on my way out, and complained to my insurance company. I should have called his boss.
  11. Visit  Quark09 profile page
    2
    I think that in some instances, the demeanor of the patient can affect the approach that healthcare providers use. In another thread (I believe the one discussing who should be responsible for non-compliant patient's healthcare) a poster remarked that her patient was not only obese, but having family sneak in food, being very demanding, etc. I tend to think that obese patients need gentle, non-judgmental education on their lifestyle choices, but it's difficult to remain that way when the patient is acting the way that poster had described.

    Personally, I have to mentally prepare myself when dealing with psychiatric patients - it's not a field I would choose to go into due to this. However, no matter what area I work in, I'm going to come into contact with them (just like with overweight/obese patients). If I go into the interaction with the attitude that they're just trying to get attention, being manipulative, or trying to "work" the all-mighty "system," then I will get nowhere with them.
    mustlovepoodles and wooh like this.
  12. Visit  Chico David RN profile page
    22
    Interesting thread. On a broader scale, how to be helpful and therapeutic with any patient who we classify in our minds as having self-distructive behaviors or whatever is a challenge for nurses. Whether it's the patient with an eating disorder, or the patient who smokes even though they have a smoking related illness, or the patient who doesn't take their meds. We tend to want to judge that person, which makes it much harder to help them.

    Disclosure: I'm the only normal weight person in my family and feel like the only reason I am normal weight is because I happen to love exercise and like it even better in large amounts. My idea of a good vacation involves things like 60 miles a day on the bike or 15 miles of hiking. So I can't claim credit for controlling my eating any better than my 400 lb sister. I just burn it off better.

    The weight issue is doubly complex because it's so multi-factorial. As a couple of commentors have mentioned, some folks become obese due to side-effects of meds or medical conditions - a small percentage of the total though. Some folks have a really profound genetic tendency that way - but that percentage of the population has probably not increased in the last 50 years, while the incidence of obesity has skyrocketed. Then we look at will and people's personal choices. That's tempting. But consider this: in the last 50 years or so, the rates of obesity in the US - and most other developed countries - have gone up enormously. The question is: Has the basic nature of people, their ability to make smart choices, their willpower, etc changed that much? I don't think so. I don't think we are that different from our parents. So why so much fat?
    I have to think that the environment we live in is different in some significant ways. The biggest one by me, is that the array of very appealing, very high calorie foods is hugely greater than it was 50 years ago. Big corporations spend millions - maybe billions - on highly technical research designed to get people to buy and consume more of their products. There are thousands of food items on the shelves - many of them very high calorie - that did not even exist when I was a child. There are very sophisticated advertising programs to get you to eat more of all that stuff.
    And then there is portion size. Does anyone else remember that in the 50s Coke came in 8oz bottles? Not 32 or 64, but 8. There wasn't much fast food around then, and what there was was small - the original Mcdonald's Burger was a little thing, and not very appetizing.
    So, yes, people do have to take some responsibility. But a couple million years of human evolution favored people who ate all the food that was available and stored fat for the next famine. Presenting people with this overwhelming flood of attractive, high calorie food and then expecting them to eat moderately is probably a losing proposition.
    More to Learn, leslie :-D, Skips, and 19 others like this.
  13. Visit  nohika profile page
    0
    Y'know, I think there's almost two TYPES of obesity. The kind a PP described - the ones that no longer care, blame it on others, sneak food in while in ICU, etc. And then there's the kind that either have psychiatric (depression, etc) or medical (steroids) issues that are causing a part (or all of) the weight gain.

    I think a lot of nurses are burned out on the first type - the one that blames it on the rest of America while eating three big macs. I'm overweight myself, and I've been tormented about it since I was in high school...and the sucky thing is, the more I'm made fun of, the more I eat. Stress-eater and all.

    I don't remember ever being commented about it disdainfully, but I only see my PCP like once a year and I've had to switch twice in the past two years due to insurance. So...
  14. Visit  HappyNurse2005 profile page
    17
    I think something else that we need to be mindful of is not jumping to conclusions about a patients weight. Maybe they are on steroids, maybe they are depressed, etc etc. Maybe they do need lifestyle modification education.

    Though, maybe that 200 pound woman, who appears to be obese, actually used to weigh 300 pounds and is now eating healthy, exercising, etc. So although she is still obese she is actually already living a healthy lifestyle and losing weight


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