Weight bias is 'unethical': UAlberta bariatric rehabilitation expert joins pledge to eradicate the stigma of obesity

Global joint consensus statement on weight discrimination published March 4 on World Obesity Day

Laurie Wang - 04 March 2020

People with obesity face social stigma that can affect the care and treatment they receive. A global joint consensus statement published on March 4 by international scientific and professional organizations is an important step to end the stigma of obesity: "Perceived-without evidence-as lazy, gluttonous, lacking will power and self-discipline, individuals suffering from obesity are often discriminated against in the workplace, educational settings and even by health-care professionals."

University of Alberta bariatrics researcher Mary Forhan, PhD, joins the world-wide pledge to eradicate weight bias and the stigma of obesity.

"Weight bias is making assumptions about a person's value, aptitude, abilities, goals and attributes based on their body size and shape. It is limiting opportunities for a person to engage and participate fully in roles and activities that are meaningful or necessary," says Forhan, on behalf of the Canadian Association of Occupational Therapists (CAOT) who has endorsed the consensus statement.

As chair of the occupational therapy department at the University of Alberta's Faculty of Rehabilitation Medicine, she believes that occupational therapists and other rehabilitation professionals are integral in being part of the solution.

"Professions such as occupational therapy and physical therapy need to understand the complexity of obesity and be sure that the services they offer consider the needs of patients living in large bodies and the needs of those living with obesity. It is incredibly important that rehabilitation professionals do not restrict access to therapeutic services such as those for osteoarthritis, neurological conditions, cardiovascular disease or mental health disorders based on a patient's body size."

Most equipment in rehabilitation settings has weight capacity limits of 113 kg (250 pounds) which can limit access to safe and appropriate care. Forhan says restricting access to treatment based on body size and shape is an example of weight bias-so is not having the appropriate equipment or supplies in a rehabilitation setting that are safe for use with patients.

"Weight bias is telling a patient they need to lose weight and not working with a patient to connect them to evidence based, legitimate weight management interventions and professionals. It is unethical."

Rehabilitation professionals aim to enhance living and quality of life for all individuals. "In my opinion, it is a professional responsibility to be sure that the places and spaces in which rehabilitation services are offered are accessible, both emotionally, psychologically and physically for persons living in a large body or who have obesity."
Evidence shows weight bias restricts access to preventative health care, acute care, higher education, workplace promotions, career development and more. The health and well-being of individuals, communities and society is at stake.

"Allowing stigmatizing images and language and actions to continue only perpetuates the violation of human rights in the workplace, schools, healthcare settings and public places," says Forhan. "Examples of weight bias are everywhere: in classrooms that do not provide seating that is accessible, public transit that is limited in a diverse seating options, retail spaces that do not provide room to move about, limited access to sizes in clothing options, hospitals that do not have beds, seating, lifts, diagnostic equipment that is accessible, and public health messages on TV or in print that perpetuate that myth that obesity is simply a result of overeating and under exercising."

The joint consensus statement condemns: "The use of stigmatizing language, images, attitudes, policies, and weight-based discrimination, wherever they occur." Published in Nature Medicine on World Obesity Day, the pledge was taken by the All-Party Parliamentary Group on Obesity, all Nature journals, University College London Hospitals NHS Foundation Trust and the World Obesity Federation. Partners in the initiative include World Obesity Federation, American Diabetes Association, European Association for the Study of Obesity, The Obesity Society, Obesity Canada, Diabetes UK and more. For more information, visit https://www.worldobesityday.org.