Friday, March 7, 2014

Treating Obese Patients Without Prejudice

By E’Louise Ondash, RN

Are some nurses biased against their obese patients?

I have to admit this is an issue that I personally struggle with at times.

Intellectually I know that there are multiple reasons for being overweight and that every patient is an individual. But I also know the health risks and problems that come with weighing too much, as well as the costs, which are often shared by others who are not obese. I am not proud that I lose patience with people who do not seem to want to lose weight or refuse to do so. I never express this impatience, but it’s there, nonetheless.

Apparently I’m not alone. Studies have shown that many health care providers are biased when it comes to obese patients, but few will admit it. 

A 2003 study in the journal Obesity Research found that more than half of the 620 U.S. doctors surveyed saw obese patients as “awkward, unattractive, ugly and noncompliant,” according to the story. In another study, it was found that nearly 2,300 physicians scored similarly to the general population when associating overweight people with negative words, and there was a strong preference for thin people.

Now consider that nearly 1 in 3 U.S. adults are considered obese, and we can see that any kind of obesity bias can lead to widespread issues with patient care.  Many overweight patients have shared their stories of medical treatment that ranged from less-than-respectful to downright degrading.

I know from talking to nurses in the primary care field and in diabetes education that obese patients are one of their greatest sources of frustration. In many cases, nurses are stumped as to how to care for overweight patients and motivate them to lose pounds and lead a healthier lifestyle.  

The reality is that obesity costs individuals a great deal when it comes to their personal health, as well as their pocketbooks.  It also drains a lot of money from the health care system. So in an era when it’s all about cutting the cost and improving the quality of health care, what can nurses and other health care providers do?

The Obesity Society, which strives to understand the causes, consequences, prevention and treatment of obesity, suggests these strategies:

• Approach patients with sensitivity; consider that they have already had negative experiences with other health care providers, and that they likely have tried to lose weight several times.
• Understand and share that obesity is a complex problem and not a problem solely associated with lack of willpower.
• Look beyond obesity for other causes of patients’ immediate complaints.
• Acknowledge that losing weight is difficult.
• Offer concrete advice.
• Recognize that even small weight losses can have positive health benefits.

There is debate among health care experts as to whether obesity is a disease or not, but there is no debate about this: We won’t accomplish a thing if, even as we assure that all citizens have health care insurance, we cannot assure that they are living healthier lives.    

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