Health care professionals are not exempt from the impact of our cultural obsession with thinness. Obese individuals are stigmatized in this society and health care providers are often no exception.¹ Consider the following:

• A review of studies shows that health care providers have negative attitudes toward large patients and are likely to discriminate in practice. ²
• A survey of health professionals found that 84% felt obese people were self-indulgent, 88% assumed eating was to cover up other problems, and 70% assumed that excess weight was caused by underlying emotional disturbance.³
• Another study showed that health care providers stated that they didn't discriminate, but they did assign negative symptoms more often to obese clients and assumed they possessed poorer mental health than their average weight counterparts.⁴
• Additionally, the belief that obese individuals eat more, exercise less, are more emotionally unstable and are less disciplined than others is a widely held professional perception.⁵

How Does This Relationship Develop?

• Health care professionals' education promotes the old paradigm which consists primarily of telling clients with weight-related concerns to attempt weight loss through restricted intake (dieting) and/or regimented physical activity (exercise).
• Such interventions rest primarily on the following three tenets:¹
• 1. Health and happiness only occur when ideal weight is obtained
• 2. People differ in size because they lack the will power to exercise regularly and restrict their food intake
• 3. Everyone can be thin, happy, and healthy by dieting
• Old Paradigm foundational concepts that are often taught as indisputable fact despite the lack of sufficient scientific support (See Unit I Lesson C) include:
• Obesity is an independent disease/risk factor in cardiovascular and other diseases
• Dieting/regimented exercise are viable intervention strategies that can "cure" obesity
• To review examples of the old paradigm literature used to educate today's health care providers look up "obesity" in any of the following (or almost any other available) texts:
• Bulecheck & McCloskey: Nursing interventions: Essential nursing treatments²
• Herfindal & Gourley: Textbook of therapeutics: Drug and disease management³
• Neinstein: Adolescent health care: A practical guide⁴
• Pender: Health promotion in nursing practice⁵
• Porth: Pathophysiology: Concepts of altered health states⁶
• Stanhope & Lancaster: Community health nursing: Process and practice for promoting health⁷

..... While alternative views and awareness of contradictory evidence are beginning to appear in educational programs, the old paradigm is still widely accepted and taught.

References
 
 

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