Title of Presentation

Understanding Primary Care Physicians’ Attitudes Towards Childhood vs Adult Obesity

Presenter Biography

We are a group of interdisciplinary students (MD/MPH and PhD) that collaboratively completed this project. Our goal is to increase awareness about institutionalized fatphobia among healthcare providers and encourage confrontation and dismantling of personal weight biases.

Institution

OHSU

Program/Major

Epidemiology

Degree

MD/MPH

Presentation Type

Presentation

Start Date

6-4-2022 4:58 PM

End Date

6-4-2022 5:09 PM

Keywords

Weight-bias, Fatphobia, Weight-stigma, Primary Care, Qualitative

Abstract

Background: Research has highlighted discriminatory attitudes towards obese patients among healthcare providers that impact health outcomes. Weight stigma causes many patients to delay or avoid seeking medical care out of fear of embarrassment, disrespectful treatment, and negative comments. We sought to explore differences in attitudes about how primary care physicians perceive conversations about weight and barriers to care in children versus adults.

Methods: Structured interviews were conducted among twelve primary care providers, including family medicine, pediatrics, and internal medicine. Questions asked touched on the following themes: factors that influence weight, usefulness/limitations of BMI, weight stigma, conversations about weight with patients, and the medicalization of obesity.

Results: There were mixed opinions about whether obesity is a disease across each specialty. Most physicians considered it a chronic disease because obesity is associated with and worsens comorbid conditions, is a predictor of health, and generally improves health if treated. BMI was found to be a convenient but profoundly flawed measure without better alternatives. Genetics, diet, and physical activity were the top three cited factors influencing weight. Examples of stigma notably differed between pediatricians and adult providers, with pediatricians focusing on social media and bullying as critical factors in developing eating disorders. Contrarily, adult providers frequently mentioned the avoidance of healthcare due to internal and external stigma.

Conclusions: Medical institutions should prioritize education regarding the structural influences on weight, such as poverty and racism, the troubling history of BMI, and the harm of pathologizing obesity. The “The Health At Every Size” principles should be prioritized to deliver equitable, trauma-informed care to all patients.

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Apr 6th, 4:58 PM Apr 6th, 5:09 PM

Understanding Primary Care Physicians’ Attitudes Towards Childhood vs Adult Obesity

Background: Research has highlighted discriminatory attitudes towards obese patients among healthcare providers that impact health outcomes. Weight stigma causes many patients to delay or avoid seeking medical care out of fear of embarrassment, disrespectful treatment, and negative comments. We sought to explore differences in attitudes about how primary care physicians perceive conversations about weight and barriers to care in children versus adults.

Methods: Structured interviews were conducted among twelve primary care providers, including family medicine, pediatrics, and internal medicine. Questions asked touched on the following themes: factors that influence weight, usefulness/limitations of BMI, weight stigma, conversations about weight with patients, and the medicalization of obesity.

Results: There were mixed opinions about whether obesity is a disease across each specialty. Most physicians considered it a chronic disease because obesity is associated with and worsens comorbid conditions, is a predictor of health, and generally improves health if treated. BMI was found to be a convenient but profoundly flawed measure without better alternatives. Genetics, diet, and physical activity were the top three cited factors influencing weight. Examples of stigma notably differed between pediatricians and adult providers, with pediatricians focusing on social media and bullying as critical factors in developing eating disorders. Contrarily, adult providers frequently mentioned the avoidance of healthcare due to internal and external stigma.

Conclusions: Medical institutions should prioritize education regarding the structural influences on weight, such as poverty and racism, the troubling history of BMI, and the harm of pathologizing obesity. The “The Health At Every Size” principles should be prioritized to deliver equitable, trauma-informed care to all patients.