Viewpoint: Care may improve if physicians stop weighing heavier patients

Although physicians are following established guidelines by weighing their patients and calculating their body mass index, providers often fail to acknowledge weight stigma as a potentially harmful effect of screening heavier patients, Rebecca Scritchfield, dietitian and certified exercise physiologist, writes in The Washington Post.

Four insights from the op-ed:

1. Ms. Scritchfield cited a review of research about weight stigma, which found 69 percent of higher weight women reported feeling stigmatized by their physician. The study authors said research shows some healthcare providers view obese patients as lazy, noncompliant and undisciplined.

2. A 2018 study on healthcare avoidance revealed a patient's BMI correlated with weight stigma, increased body shame and higher healthcare stress. "Ultimately, some higher weight patients give up on their doctor visits altogether as an attempt to escape their stress and anxiety around healthcare encounters," Ms. Scritchfield writes.

3. The U.S. Preventive Task Force recommends physicians screen all adults for obesity by weighing them, calculating their BMI and referring those with BMIs of 30 or greater to intensive behavioral interventions, Ms. Scritchfield writes.

"However, the recommendation does not acknowledge weight stigma as a possible harm of the screening, nor does it suggest asking the patient for consent to do the screening," Ms. Scritchfield says. "Patients have the right to decline being weighed, as with any other medical screening, but that's not necessarily obvious since most medical practices weigh patients before they even get to see the doctor."

4. To improve care quality, Ms. Scritchfield says physicians could stop using BMI to start conversations on behavior changes and instead collaborate with their patients on maintaining healthy habits, regardless of their weight. "This approach would probably reduce body shame and weight stigma, and improve healthcare," she writes.

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