Over the Thanksgiving weekend, my cousin shared details of what she and her 14-year-old daughter experienced when they last visited the pediatrician. She began expressing her experience by stating that the waiting lobby had no chairs that could accommodate her daughter. She detailed that there were adult chairs, which were not designed for adults with overweight statuses, and small plastic chairs for little children. She shared that she and her daughter were embarrassed when the receptionist loudly announced to them that her daughter could stand until called on in a derogatory tone. She added that parents and children in the waiting room were snickering.
My cousin continued to describe the rest of the visit which included her child’s weight being taken on a scale in the hall with no privacy. She added that the nurse yelled “wow” before announcing the weight for others to hear.
Additionally, the clinic had no paper gowns that would fit her daughter, so the nurse asked them to drape a gown on the front with an additional gown on her back side. My cousin ended her story by sharing that the doctor was very discouraging to her daughter. My cousin shared that the doctor told her daughter that she would have a difficult time finding a boyfriend, getting accepted into college, and having friends if she didn’t lose weight fast. My cousin told me that she asked her 14-year-old daughter to get dressed, and they left without receiving any medical care.
Unfortunately, many patients living with an overweight status, including children, experience some level of my cousin’s experience when visiting their doctor’s office. The research has overwhelmingly demonstrated that this is not helpful, but hurtful, to the success of a patient achieving a higher level of health. There are many research studies revealing various sources of negative stigma originating from healthcare facilities. Much of the negative stigma originates with the medical providers and staff.
This same research overwhelmingly concludes that this is detrimental to a patient’s health. Some of the consequences include avoidance of visiting doctors’ offices. This can result in missed opportunities for healthcare, including yearly wellness physicals. During these missed wellness physicals, medical and psychological conditions can be diagnosed to include decreased vision, elevated blood pressure, and ADHD. This can result in decreased ability to perform in school. With early diagnosis, through regular screenings during annual wellness exams, these conditions have a higher probability of successful treatment before negatively impacting the child’s academic performance.
There has also been research proven that the usage of “shaming” a person, children included, as a technique to obtain a healthier weight, can cause more harm than good in many scenarios. The research demonstrates that this can cause increases in stress hormones such as cortisol. This causes a person to eat more and have a harder time avoiding unhealthy (comfort) foods. This can also result in a person feeling discouraged and unmotivated to eat healthy and exercise. The eventual result is a decreased probability of achieving a healthier weight.
The ANSWER is for more of the medical community to seek a higher level of understanding of the negative effects of a patient’s experiences when they have an encounter such as the patient noted in this article. We, in the medical community, have to understand the consequences of having negative weight bias. By definition, having weight bias is having negative attitudes towards, and beliefs about, others because of their weight. Many with this bias exhibit the inclination to form unreasonable judgements based on a person’s weight. This is caused by a general belief that stigma and shame will motivate people to lose weight or the belief that people fail to lose weight as a result of inadequate self-discipline or insufficient will-power.
We, in the medical community, have to be more aware through education of ourselves and our staff and not place blame on patients and/or parents. We have to use language that is more positively received. This means using descriptions that include healthier eating and physical activity as opposed to diet and exercise. We can also use better received wording to include unhealthy BMI rather than obesity and never use the word “FAT”. We can focus on achievements and make all efforts to make patients and families feel safe, heard, and respected. Most importantly, we have to understand that our ATTITUDES have to be part of the solution.