Weight bias: A consideration for medical radiation sciences
2022; Elsevier BV; Volume: 53; Issue: 4 Linguagem: Inglês
10.1016/j.jmir.2022.08.012
ISSN1939-8654
Autores Tópico(s)Empathy and Medical Education
ResumoThe healthcare system is obsessed with large bodied patients. It is determined to eradicate fatness, while also sending strong messages to large bodied patients that "you are not welcome here". Despite nearly 1.9 billion people are living in large bodies,1World Health OrganizationObesity. World Health Organization, Geneva (CH)2022https://www.who.int/health-topics/obesity#tab=tab_1Google Scholar negative attitudes about large body weight and size remains one of the last socially acceptable prejudices.1World Health OrganizationObesity. World Health Organization, Geneva (CH)2022https://www.who.int/health-topics/obesity#tab=tab_1Google Scholar, 2Gordon A. What We Don't Talk About When We Talk About Fat. Beacon Press, Boston(MA)2005Google Scholar Healthcare providers often have strong negative opinions about and intentionally discriminate against large bodied patients.3Puhl R.M. Luedicke J. Grilo C.M. Obesity bias in training: attitudes, beliefs, and observations among advanced trainees in professional health disciplines.Obesity. 2014; 22 (Silver Spring): 1008-1015Crossref PubMed Scopus (81) Google Scholar,4Phelan S.M. Burgess D.J. Yeazel M.W. Hellerstedt W.L. Griffin J.M. van Ryn M. Impact of weight bias and stigma on quality of care and outcomes for patients with obesity.Obes Rev. 2015; 16 (Apr): 319-326Crossref PubMed Scopus (525) Google Scholar Weight bias or weight stigma is a social rejection, discrimination, exclusion, and devaluation based on person's body weight, shape, or size.5Rubino F. Puhl R.M. Cummings D.E. et al.Joint international consensus statement for ending stigma of obesity.Nat Med. 2020; 26: 485-497Crossref PubMed Scopus (251) Google Scholar,6The Lancet Public HealthAddressing weight stigma.Lancet Public Health. 2019; 4 (Apr): e168Abstract Full Text Full Text PDF PubMed Scopus (14) Google Scholar This weight stigma is pervasive in both society and in healthcare, framing large bodies as a public health epidemic and reinforcing slim bodies as healthy and ideal.4Phelan S.M. Burgess D.J. Yeazel M.W. Hellerstedt W.L. Griffin J.M. van Ryn M. Impact of weight bias and stigma on quality of care and outcomes for patients with obesity.Obes Rev. 2015; 16 (Apr): 319-326Crossref PubMed Scopus (525) Google Scholar,7Talumaa B. Brown A. Batterham R.L. Kalea A.Z. Effective strategies in ending weight stigma in healthcare.Obes Rev. 2022; : e13494PubMed Weight stigma persists in part because there is discrepancy between the science of large bodies and public narrative around them.5Rubino F. Puhl R.M. Cummings D.E. et al.Joint international consensus statement for ending stigma of obesity.Nat Med. 2020; 26: 485-497Crossref PubMed Scopus (251) Google Scholar There is an incorrect presumption that a person's weight stems from a personal failing such as a lack of self-control, self-discipline, or personal responsibility.2Gordon A. What We Don't Talk About When We Talk About Fat. Beacon Press, Boston(MA)2005Google Scholar, 5Rubino F. Puhl R.M. Cummings D.E. et al.Joint international consensus statement for ending stigma of obesity.Nat Med. 2020; 26: 485-497Crossref PubMed Scopus (251) Google Scholar Evidence demonstrates a person's body habitus is affected by a combination of genetic, environmental, and social factors, where efforts to lose weight can activate compensatory biologic responses resulting in weight regain.5Rubino F. Puhl R.M. Cummings D.E. et al.Joint international consensus statement for ending stigma of obesity.Nat Med. 2020; 26: 485-497Crossref PubMed Scopus (251) Google Scholar Weight bias and stigma causes harm, affects access to adequate care, and damages health.4Phelan S.M. Burgess D.J. Yeazel M.W. Hellerstedt W.L. Griffin J.M. van Ryn M. Impact of weight bias and stigma on quality of care and outcomes for patients with obesity.Obes Rev. 2015; 16 (Apr): 319-326Crossref PubMed Scopus (525) Google Scholar,2Gordon A. What We Don't Talk About When We Talk About Fat. Beacon Press, Boston(MA)2005Google Scholar, 5Rubino F. Puhl R.M. Cummings D.E. et al.Joint international consensus statement for ending stigma of obesity.Nat Med. 2020; 26: 485-497Crossref PubMed Scopus (251) Google Scholar,8Drury C.A. Louis M. Exploring the association between body weight, stigma of obesity, and health care avoidance.J Am Acad Nurse Pract. 2002; 14 (Dec): 554-561Crossref PubMed Google Scholar Patients with large body habitus delay or avoid healthcare for a variety of reasons including weight changes since prior visit, not wanting to be weighed, knowing they'd be told to lose weight, potential embarrassment and mistrust.4Phelan S.M. Burgess D.J. Yeazel M.W. Hellerstedt W.L. Griffin J.M. van Ryn M. Impact of weight bias and stigma on quality of care and outcomes for patients with obesity.Obes Rev. 2015; 16 (Apr): 319-326Crossref PubMed Scopus (525) Google Scholar,2Gordon A. What We Don't Talk About When We Talk About Fat. Beacon Press, Boston(MA)2005Google Scholar, 8Drury C.A. Louis M. Exploring the association between body weight, stigma of obesity, and health care avoidance.J Am Acad Nurse Pract. 2002; 14 (Dec): 554-561Crossref PubMed Google Scholar These stigmatizing experiences result in negative engagement, increased allostatic load, inflammation, depression, anxiety, maladaptive coping, poorer care outcomes and increased morbidity.4Phelan S.M. Burgess D.J. Yeazel M.W. Hellerstedt W.L. Griffin J.M. van Ryn M. Impact of weight bias and stigma on quality of care and outcomes for patients with obesity.Obes Rev. 2015; 16 (Apr): 319-326Crossref PubMed Scopus (525) Google Scholar,7Talumaa B. Brown A. Batterham R.L. Kalea A.Z. Effective strategies in ending weight stigma in healthcare.Obes Rev. 2022; : e13494PubMed ,9Phelan S.M. Bauer K.W. Bradley D. et al.A model of weight-based stigma in health care and utilization outcomes: evidence from the learning health systems network.Obes Sci Pract. 2021; : 1-8https://doi.org/10.1002/osp4.553Crossref Scopus (4) Google Scholar,10Alberga A.S. Edache I.Y. Forhan M. Russell-Mayhew S. Weight bias and health care utilization: a scoping review.Prim Health Care Res Dev. 2019; 20 (Published 2019 Jul 22): e116https://doi.org/10.1017/S1463423619000227Crossref PubMed Scopus (59) Google Scholar The presumption of health is not afforded to those with large body habitus who are often assumed to be unfit, unhealthy, or living with chronic illnesses. Weight-Distraction occurs when healthcare provider weight bias puts patients in large bodies as risk of misdiagnosis.9Phelan S.M. Bauer K.W. Bradley D. et al.A model of weight-based stigma in health care and utilization outcomes: evidence from the learning health systems network.Obes Sci Pract. 2021; : 1-8https://doi.org/10.1002/osp4.553Crossref Scopus (4) Google Scholar,11Paine E.A. Fat broken arm syndrome": Negotiating risk, stigma, and weight bias in LGBTQ healthcare.Soc Sci Med. 2021; 270 (Feb)113609Crossref PubMed Scopus (14) Google Scholar Patients with a large body habitus experience stigma and discrimination as a direct result of how their bodies appear, with judgements of their health status being made prior to investigation or without gathering of medical history. As a result, health concerns are dismissed or falsely attributed to a patient's body size rather than investigated for possible (and often typical) causes.11Paine E.A. Fat broken arm syndrome": Negotiating risk, stigma, and weight bias in LGBTQ healthcare.Soc Sci Med. 2021; 270 (Feb)113609Crossref PubMed Scopus (14) Google Scholar The pervasiveness, impact and complications arising from these biases lead Nature and the Lancet to acknowledge that healthcare provider weight biases and associated negative perceptions of large bodied patients are ubiquitous.5Rubino F. Puhl R.M. Cummings D.E. et al.Joint international consensus statement for ending stigma of obesity.Nat Med. 2020; 26: 485-497Crossref PubMed Scopus (251) Google Scholar,6The Lancet Public HealthAddressing weight stigma.Lancet Public Health. 2019; 4 (Apr): e168Abstract Full Text Full Text PDF PubMed Scopus (14) Google Scholar,10Alberga A.S. Edache I.Y. Forhan M. Russell-Mayhew S. Weight bias and health care utilization: a scoping review.Prim Health Care Res Dev. 2019; 20 (Published 2019 Jul 22): e116https://doi.org/10.1017/S1463423619000227Crossref PubMed Scopus (59) Google Scholar They've called for research to address the gap that exists between scientific evidence and the ongoing misconceptions reinforcing weight bias and stigma.5Rubino F. Puhl R.M. Cummings D.E. et al.Joint international consensus statement for ending stigma of obesity.Nat Med. 2020; 26: 485-497Crossref PubMed Scopus (251) Google Scholar,6The Lancet Public HealthAddressing weight stigma.Lancet Public Health. 2019; 4 (Apr): e168Abstract Full Text Full Text PDF PubMed Scopus (14) Google Scholar The language used when talking about body size matters because it indicates underlying presumptions, attitudes, and biases. In healthcare, terms like obesity (disease involving excessive body fat and weight grossly above recommended stan-dards)12Mayo ClinicObesity. Mayo Clinic, Rochester (NY)2022https://www.mayoclinic.org/diseases-conditions/obesity/symptoms-causes/syc-20375742#:~:text=Obesity%20is%20a%20complex%20disease,blood%20pressure%20and%20certain%20cancersGoogle Scholar,13MeSH Browser [Internet]. Bethesda (MD): U.S. national library of medicine; 2002. Meta-analysis; [cited 2022 Feb 11]; [about 1 p.]. Available from https://www.ncbi.nlm.nih.gov/mesh/68009765Google Scholar and bariatrics (field of medicine focused on treatment, weight reduction and study of obesity)14Penn Medicine. What does bariatric mean? [Internet]. Philadelphia (PA): The Trustees of the University of Pennsylvania; 2019 [cited 2022 Feb 11] Available from https://www.pennmedicine.org/updates/blogs/metabolic-and-bariatric-surgery-blog/2019/april/what-does-bariatric-mean.Google Scholar,15MeSH Browser [Internet]. Bethesda (MD): U.S. national library of medicine; 2002. Meta-analysis; [cited 2022 Feb 11]; [about 1 p.]. Available from https://www.ncbi.nlm.nih.gov/mesh/68049088Google Scholar apply a medicalized lens to the existence of large bodies.2Gordon A. What We Don't Talk About When We Talk About Fat. Beacon Press, Boston(MA)2005Google Scholar The word obesity derives from the Latin obesus which means having eaten oneself fat. This is both an offensive an inaccurate explanation for large bodies. Be it euphemisms (e.g. big boned, fluffy, plus size etc) or medicalized terms; these words are value based and imply inherent moral failing, shame, or deviance from what is considered "normal".7Talumaa B. Brown A. Batterham R.L. Kalea A.Z. Effective strategies in ending weight stigma in healthcare.Obes Rev. 2022; : e13494PubMed ,2Gordon A. What We Don't Talk About When We Talk About Fat. Beacon Press, Boston(MA)2005Google Scholar The words, expressions, and context of how large bodies are described is a key indicator of weight bias and stigma within medical literature. A quick search of medical radiation science (MRS) publications yielded several articles where a patient's body size is part of a pun or joke in the title of academic article. While the intent of these jokes in titles may not have been to harm a large bodied person, it is evidence of the pervasiveness of weight bias and stigma. Consider that these titles made it through the peer review process and into the annals of medical science literature without being questioned or cautioned. The inclusion of terms like the BIG picture, BIG issue, FAT chance in titles of papers, or colloquialisms using large bodied opera singers as the punchline, only serve to reinforce weight bias and stigma within our professional literature. It then becomes obvious why recommendations to address weight bias include being thoughtful and intentional with language use and word choice in order to avoid perpetuating stigma, discrimination, and harm To that end, the Joint International Consensus Statement for Ending Stigma of Obesity calls for using inclusive language when writing about patients with large body habitus to help combat weight bias and weight stigma5Rubino F. Puhl R.M. Cummings D.E. et al.Joint international consensus statement for ending stigma of obesity.Nat Med. 2020; 26: 485-497Crossref PubMed Scopus (251) Google Scholar. Although medical radiation technologists (MRTs) are expected to provide care in an unbiased manner that respects the dignity, privacy and autonomy of our patients, weight bias and stigma diminishes that capacity.16CAMRT. National competency profile for entry-level MRTs in Canada. 2020; [cited 2022 Feb 11]. Available from https://www.camrt.ca/wp-content/uploads/2020/03/National-Competency-Profile-2019.pdf.Google Scholar, 17Aweidah L. Robinson J. Cumming S. Lewis S. Australian diagnostic radiographers' attitudes and perceptions of imaging obese patients: a study of self, peers and students.Radiography. 2016; 22: e258-e263Abstract Full Text Full Text PDF Scopus (6) Google Scholar A closer look at the medical radiation science literature reveals that MRTs, like other healthcare professionals, have demonstrated significant negative implicit weight bias regarding large bodied patients that included feelings of blame and frustration.17Aweidah L. Robinson J. Cumming S. Lewis S. Australian diagnostic radiographers' attitudes and perceptions of imaging obese patients: a study of self, peers and students.Radiography. 2016; 22: e258-e263Abstract Full Text Full Text PDF Scopus (6) Google Scholar MRTs care for millions of patients each year and weight bias has the potential to impact their care experience. Typically, MRTs are adept at accommodating individual needs providing not only competent care, but adjusting our approach to meet the needs of our patients. That same courtesy is not always afforded to large bodied patients who have been provided inadequate resources to support their care or blamed for placing an increased demand on MRT departments.2Gordon A. What We Don't Talk About When We Talk About Fat. Beacon Press, Boston(MA)2005Google Scholar, 17Aweidah L. Robinson J. Cumming S. Lewis S. Australian diagnostic radiographers' attitudes and perceptions of imaging obese patients: a study of self, peers and students.Radiography. 2016; 22: e258-e263Abstract Full Text Full Text PDF Scopus (6) Google Scholar, 18Mazziotta J. Singer Mary Lambert shares a 'Triggering Experience' getting an MRI as a 'Fat Patient'[Internet] New York (NY). Meredith Corporation. [cited 2022 Feb 11]. Available from https://people.com/health/singer-mary-lambert-shares-a-triggering-experience-getting-an-mri-as-a-fat-patient/Google Scholar, 19Ghanem M.A. Kazim N.A. Elgazzar A.H. Impact of obesity on nuclear medicine imaging.J Nucl Med Technol. 2011; 39 (Mar): 40-50Crossref PubMed Scopus (27) Google Scholar, 20Puhl R.M. Heuer C.A. Obesity stigma: important considerations for public health.Am J Public Health. 2010; 100: 1019-1028https://doi.org/10.2105/AJPH.2009.159491Crossref PubMed Scopus (1040) Google Scholar In the MRS literature, interactions with large bodied patients have been described as embarrassing, inconvenient, and challenging (difficulty positioning and palpating, increased radiation dose, etc.).21Uppot R.N. Technical challenges of imaging & image-guided interventions in obese patients.Br J Radiol. 2018; 91 (Sep)20170931PubMed Google Scholar,22Le N.T. Robinson J. Lewis S.J. Obese patients and radiography literature: what do we know about a big issue?.J Med Radiat Sci. 2015; 62 (Jun): 132-141Crossref PubMed Scopus (35) Google Scholar,23Miller P.K. Woods A.L. Sloane C. Booth L. Obesity, heuristic reasoning and the organisation of communicative embarrassment in diagnostic radiography.Radiography. 2017; 23 (Lond): 130-134Abstract Full Text Full Text PDF PubMed Scopus (9) Google Scholar, 24van den Heuvel J. Punch A. Aweidah L. Meertens R. Lewis S. Optimizing projectional radiographic imaging of the abdomen of obese patients: an e-Delphi study.J Med Imaging Radiat Sci. 2019; 50 (Jun): 289-296Abstract Full Text Full Text PDF PubMed Scopus (3) Google Scholar, 25Thanh Le N.T. Robinson J. Jayne Lewis S. A study of student radiographers' learning experiences in imaging obese patients.J Med Imaging Radiat Sci. 2015; 46 (Sep): S61-S68Abstract Full Text Full Text PDF PubMed Scopus (7) Google Scholar, 26Destounis S. Newell M. Pinsky R. Breast imaging and intervention in the overweight and obese patient AJR.Am J Roentgenol. 2011; 196: 296-302Crossref PubMed Scopus (24) Google Scholar, 27Winters E. Poole C. Challenges and impact of patient obesity in radiation therapy practice.Radiography. 2020; 26 (Lond): e158-e163Abstract Full Text Full Text PDF PubMed Scopus (2) Google Scholar, 28Carucci L.R. Imaging obese patients: problems and solutions.Abdom Imaging. 2013; 38 (Aug): 630-646Crossref PubMed Scopus (50) Google Scholar Our departments, by design, make access and care of large bodied patients inadequate; waiting room seats too small, hospital gowns too tight, scrubs sizes too limited, tourniquets too short, scanner bores too tight, weight limits insufficient, or the imaging/therapy table too narrow.21Uppot R.N. Technical challenges of imaging & image-guided interventions in obese patients.Br J Radiol. 2018; 91 (Sep)20170931PubMed Google Scholar,29Corwin A. Aresty A. Chong S. et al.Will they fit? Development of a measurement device to assess body habitus compatibility with MRI bore diameter for emergency trauma imaging.Emerg Radiol. 2012; 19 (Apr): 141-148Crossref PubMed Scopus (7) Google Scholar,30Smith B. Working with obese patients in radiography.J Med Imaging Radiat Sci. 2012; 43: S43PubMed Google Scholar These examples are evidence of subtle weight stigmatization in healthcare that signal to a large bodied person, "this place was not made for you".7Talumaa B. Brown A. Batterham R.L. Kalea A.Z. Effective strategies in ending weight stigma in healthcare.Obes Rev. 2022; : e13494PubMed The national competency profile for MRTs in Canada requires the provision of compassionate care for patients that includes the adaptation of positioning or protocols according to patient condition, enhance their comfort, and adapt to individual patient needs16CAMRT. National competency profile for entry-level MRTs in Canada. 2020; [cited 2022 Feb 11]. Available from https://www.camrt.ca/wp-content/uploads/2020/03/National-Competency-Profile-2019.pdf.Google Scholar Advocating for patients by identifying environmental factors in the clinical setting that impact care delivery is also a core competency. Recently, Seo et al. included a discussion of the shift in perspective to include patient comfort when caring for large bodied patients .33Seo G. Robinson J. Punch A. Jimenez Y. Lewis S. Understanding radiographic decision-making when imaging obese patients: a think-aloud study.J Med Radiat Sci. 2021; 69 (Sep 8): 13-23Crossref PubMed Scopus (3) Google Scholar Uppot et al. provided thoughtful solutions and adaptations when providing care that meets the needs of large bodied patients 21Uppot R.N. Technical challenges of imaging & image-guided interventions in obese patients.Br J Radiol. 2018; 91 (Sep)20170931PubMed Google Scholar. These indicate thoughtful considerations for caring for large bodied patients within the MRS is beginning, but there is still a considerable amount of work to do. Education about anti-fat bias and its harms is critical for dismantling and reducing experiences of weight bias and stigma and associated harms for patients. Incorporating weight bias and stigma content into the curriculum and professional development for MRTs as part of core person centered care learning is essential. We must take an active role to combat these negative perceptions and attitudes in our departments to provide best care. Providing learners with tools to identify potential barriers to care for large bodied patients should be part of the preparation to meet basic care competencies. Pedagogical strategies such as lectures, video watching, as well as arts based interactive and small groups sessions, have been found to reduce explicit weight stigma in medical students.31Matharu K. Shapiro J.F. Hammer R.R. Kravitz R.L. Wilson M.D. Fitzgerald F.T. Reducing obesity prejudice in medical education.Educ Health. 2014; 27 (Abingdon)Sep-Dec: 231-237Crossref PubMed Scopus (25) Google Scholar,32Wijayatunga N.N. Kim Y. Butsch W.S. Dhurandhar E.J. The effects of a teaching intervention on weight bias among kinesiology undergraduate students.Int J Obes. 2019; 43 (Lond)Nov: 2273-2281Crossref Scopus (12) Google Scholar Regarding the propensity to blame patients for their large body size, one study found that following sessions about weight bias and the uncontrollable contributing factors (genetics, medications etc.), there was a significant reduction in explicit bias blame scores. However, when education about body size was limited to the traditional diet and exercise-based content, implicit bias increased.32Wijayatunga N.N. Kim Y. Butsch W.S. Dhurandhar E.J. The effects of a teaching intervention on weight bias among kinesiology undergraduate students.Int J Obes. 2019; 43 (Lond)Nov: 2273-2281Crossref Scopus (12) Google Scholar Communication also plays an essential role in combatting weight stigma. Smith highlighted the need for sensitivity and communication training to build capacity in caring for large bodied patients in radiography.30Smith B. Working with obese patients in radiography.J Med Imaging Radiat Sci. 2012; 43: S43PubMed Google Scholar Evidence has shown considerate communication that is empathetic and non-stigmatizing can improve health motivation, compliance, and trust of healthcare providers' advice.7Talumaa B. Brown A. Batterham R.L. Kalea A.Z. Effective strategies in ending weight stigma in healthcare.Obes Rev. 2022; : e13494PubMed Education targeted at identifying previous communication short-comings or biases in old behaviours, as well as preparing and practicing new approaches had improved learners' communication style. Having role models and mentors model weight inclusive practice has both immediate and long-term effects on learners' attitudes and perceptions of caring for large bodied patients.3Puhl R.M. Luedicke J. Grilo C.M. Obesity bias in training: attitudes, beliefs, and observations among advanced trainees in professional health disciplines.Obesity. 2014; 22 (Silver Spring): 1008-1015Crossref PubMed Scopus (81) Google Scholar,7Talumaa B. Brown A. Batterham R.L. Kalea A.Z. Effective strategies in ending weight stigma in healthcare.Obes Rev. 2022; : e13494PubMed To that end, with many MRS departments in teaching hospitals, it is also important to consider the influence of senior staff where attitudes, weight bias and inclusivity may influence the perspective of students and new MRTs.3Puhl R.M. Luedicke J. Grilo C.M. Obesity bias in training: attitudes, beliefs, and observations among advanced trainees in professional health disciplines.Obesity. 2014; 22 (Silver Spring): 1008-1015Crossref PubMed Scopus (81) Google Scholar,7Talumaa B. Brown A. Batterham R.L. Kalea A.Z. Effective strategies in ending weight stigma in healthcare.Obes Rev. 2022; : e13494PubMed ,25Thanh Le N.T. Robinson J. Jayne Lewis S. A study of student radiographers' learning experiences in imaging obese patients.J Med Imaging Radiat Sci. 2015; 46 (Sep): S61-S68Abstract Full Text Full Text PDF PubMed Scopus (7) Google Scholar Providing preceptor education around weight stigma may help to reduce future weight bias in themselves and their students. Actively tackling weight bias and stigma can help address health disparities for large bodied patients within MRS departments. Initiatives can start at the local department level, at the point of care. This may include information sharing with colleagues about the harms of weight bias within our departments, ensuring inclusive language is used, and challenging assumptions. Determining barriers to inclusive care within MRS departments for large bodies patients is important. Consider doing an audit of the size-limiting factors in your workplace (Table 1) . These considerations can help identify departmental areas for improvement in caring for large bodied patients. Knowledge of current barriers can also be used to inform future departmental planning.Table 1Audit of departmental size-limiting factorsConsiderations:Response:Are sturdy chairs without arms available in-patient areas?Are large wheelchairs available for use if necessary?Are spacious universal change rooms available?What is the size range of scrubs or hospital gowns available to patients? Are large sizes or alternatives available?What are the weight limits of your equipment? Is that information posted in a high visibility location?What is the bore/gantry size of your equipment? How does that translate to size limitations for patients? Is that information posted in a high visibility location? Is that information readily available to patients? Is prescreening done to avoid patient embarrassment?Are there straps/supports/cushions available for comfort?Are longer needles, longer tourniquets and large blood-pressure cuffs available?Are there policies or protocols for caring for large patients if they are not able to be accommodated by the equipment? Open table in a new tab Addressing weight bias and stigma in MRS is paramount to best care, with MRTs at the core of healthcare provision for so many patients. Beyond the physical aspects of MRS departments, changes in attitude and beliefs among healthcare professionals are crucial in reducing weight bias and stigma and improving patient outcomes.4Phelan S.M. Burgess D.J. Yeazel M.W. Hellerstedt W.L. Griffin J.M. van Ryn M. Impact of weight bias and stigma on quality of care and outcomes for patients with obesity.Obes Rev. 2015; 16 (Apr): 319-326Crossref PubMed Scopus (525) Google Scholar,5Rubino F. Puhl R.M. Cummings D.E. et al.Joint international consensus statement for ending stigma of obesity.Nat Med. 2020; 26: 485-497Crossref PubMed Scopus (251) Google Scholar,34Alberga A.S. Pickering B.J. Alix Hayden K. et al.Weight bias reduction in health professionals: a systematic review.Clin Obes. 2016; 6 (JunPMID: 27166133): 175-188https://doi.org/10.1111/cob.12147Crossref PubMed Google Scholar Education, training, and inclusive academic writing are key target areas for alleviating weight bias and stigma in MRS. Rather than blaming large bodied patients for inconveniencing workflow, we need to commit to reducing barriers and biases impacting the care received. MRTs have a tremendous capacity for compassion in the care we provide. It is important when caring for large bodied patients that we preserve the dignity of those in our charge. Aug 7. https://onlinelibrary.wiley.com/doi/10.1111/obr.13494. In press.
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