Obesity medicine expert says weight bias by physicians harms patients

Thursday, September 29, 2016

Nearly 70 percent of obese patients have encountered weight bias from a physician, leading many to avoid getting the health care they need, Colony Fugate, D.O., clinical professor of pediatrics, recently told attendees of the 121st Osteopathic Medical Conference and Exposition in Anaheim, California.

As a result, patients with obesity are more likely to delay or cancel appointments, avoid preventative care and engage in unhealthy weight control measures or binge eating, research shows.

“Obesity is not a matter of willpower. It’s a complex condition with negative impacts on a patient’s mind, body and spirit,” Fugate said. “Confronting our attitudes toward this disease is an important facet of providing high-quality care for patients.”

Fugate was certified last year as a Diplomate of the American Board of Obesity Medicine, a specialist in obesity medicine. As of Sept. 22, she is one of 17 who have received the obesity medicine certification from the ABOM and one of only two in Tulsa and northeastern Oklahoma.

Funding for less stigmatized diseases than obesity is significantly higher, partly because of weight bias among physicians, she said.

“Public health officials abdicate responsibility by focusing on individual control, rather than addressing the complex etiologies of obesity,” Fugate said. “As an osteopathic physician, I encourage my colleagues to see the person inside the patient first and deal with the medical concern that brought them to the office, rather than assuming the patient's excess weight is their primary issue.”

To address weight bias, Fugate recommends that physicians recognize that genetics, biology, cultural influences, environment and individual behavior contribute to obesity.

Other strategies that can be used to reduce weight bias include approaching patients with empathy, asking permission to discuss a patient’s weight, acknowledging that most patients have tried to lose weight and equipping the medical office with larger weight scales, gowns, chairs and blood pressure cuffs.

The failure to acknowledge weight bias decreases the physician's ability to prevent disease, which is a basic philosophy of osteopathic medicine, Fugate said. It also hinders their effectiveness in improving patients' health.

"The overriding goal in osteopathic medicine is to promote patient health and well-being,” she said. “By reflecting on our biases, all physicians can improve the quality of care they provide to patients with obesity and I encourage health care providers to analyze the literature with an eye toward compassionate care."