There are many types of bias within our culture, both Implicit, the unknown bias, and Explicit, the known bias. As human beings, we are not faultless or immune to bias. How we choose to deal with our biases determines our cultural competence. As a health care professional in the family Nurse Practitioner track, I have done some soul searching to determine where my biases lie. One bias that sticks out as being present in my nursing practice is obese people.
Obesity is a stigmatized state of being which often is characterized by overweight person being thought of as lazy, incompetent and having lower social status (Tanneberger & Ciupitu-Plath, 2018). Often obesity is viewed as a choice. The blame is placed on the lack of will power and that the patient does not see a need to lose weight. Health problems would just disappear if “they would just lose the weight”. Factors such as environment and medical conditions are trivialized. Because of these types of bias, patients feel minimalized. This creates a negative impact on the patient’s ability to cope with their condition. They may avoid seeking medical care or turn to binge eating to reduce their stress. Increased psychological disorders can also be related to the bias (Bernecki DeJoy & Bittner, 2015). The bias and the stigma that comes from it decreases positive patient outcomes.
Obese patients feel if they are scorned and often delay getting treatment for fear of shaming. Nurse practitioners have shown negative views and perceptions regarding obese patients and spend less time with them with the thought that they don’t care enough to maintain a healthy weight. The problem that exists is lack of obesity management training for healthcare professionals (Fruh, et al., 2016) Until these biases and the lack of obesity management training are addressed in the healthcare field, many obese patients will not get the care they deserve.
Education is the key to reducing obesity bias. By providing information that obesity is a multipart disease with many causes, like genetic, biological, and noncontrollable aspects, negative attitudes decreased (Fruh, et al., 2016). For me, the hospital that I work for has a large Bariatric program. To become a Bariatric Center of Excellence, many bariatric sensitive services were put in place. Making accommodations in seating, wheelchairs and gowns make the patients in this program feel comfortable. Also implemented was hospital wide bariatric sensitivity training. Because of the distinction of being a center of excellence, healthcare practitioners have resources to help with bariatric medical management. As we educate and implement obesity sensitivity training, we can create a better understanding and care for bariatric patients more effectively.
- Bernecki DeJoy, S., & Bittner, K., Obesity Stigma as a Determinant of Poor Birth Outcomes in Women with High BMI: A Conceptual Framework, Maternal and Child Health Journal (2015), 19(4), 693-699.
- Tanneberger, A., & Ciupitu-Plath, Nurses’ Weight Bias in Caring for Obese Patients: Do Weight Controllability Beliefs Influence the Provision of Care to Obese Patients?, Clinical Nursing Research (2018), 27(4), 414-432.
- Fruh, S. M., Nadglowski, J., Hall, H. R., Davis, S. L., Crook, E. D., & Zlomke, K. (2016). Obesity Stigma and Bias. The Journal for Nurse Practitioners,12(7), 425-432.