What Makes Obesity So Challenging in Healthcare?

Mississippi continues to lead the nation in both adult and childhood obesity. Approximately 41% of adults in Mississippi have body mass indices (BMIs) greater than 30, putting them in the category of obesity. Nearly one in five children in Mississippi also are considered obese. The Covid-19 pandemic has contributed to an increase in obesity among both adults and children, obesity-related health illnesses, and increased healthcare expenditures here in our state.

Obesity is a challenging health issue for patients, healthcare providers, and healthcare organizations. Being a complex, multifactorial disease, it increases the risk of chronic illnesses such as type 2 diabetes, hypertension, osteoarthritis, cardiovascular disease and several cancers, such as breast cancer, endometrial cancer, and colon cancer. Obesity also contributes to the escalation of health care expenditures, and the economic impact extends far beyond the direct costs of healthcare services.

Patients diagnosed with obesity may face many obstacles as recipients of healthcare services. Patients have reported feeling stigmatized and discriminated against in the healthcare setting.¹ Healthcare providers across several disciplines have also reported having negative attitudes about obese patients.^2–5 Due to patient perceptions and the attitudes of some healthcare providers, obesity stigma can affect clinical outcomes and the quality of care.

Interactions perceived as unfavorable could contribute to counterproductive behaviors. Weight bias in healthcare settings can create a vicious cycle whereby bias and obesity lead to health consequences, increased medical visits, more discrimination, negative feelings, avoidance of healthcare, unhealthy behaviors, poor self-care, and obesity.

How do we as healthcare providers in a state with the highest rate of obesity in the nation begin to tackle this problem? We can first start examining our own implicit or explicit biases about patients with obesity. The Harvard Implicit Association Test (IAT) on weight is easily accessible at Project Implicit at https://implicit.harvard.edu. Secondly, obesity awareness should become a priority, like diversity, inclusion, and cultural competency. We can examine our verbal and non-verbal communication to provide a welcoming environment using people-first language. Get rid of unacceptable terminology such as obese patients, morbidly obese, and fat. But instead, use the acceptable terminology of a patient with obesity; weight problem, unhealthy weight, or high BMI.

As a healthcare provider and a patient with obesity, I realize that this is an enormous challenge. However, I believe that Mississippi healthcare providers are capable of a challenge.