Patients with obesity often encounter bias and discomfort in healthcare settings, which can deter them from seeking necessary medical care. To ensure all patients feel welcomed and respected, medical offices should strive to create an inclusive, stigma-free environment. This involves thoughtful consideration of office furniture, appropriately sized medical equipment, the use of patient-first language, and carefully curated reading materials. Here’s how you can make your practice more inclusive and supportive for patients with obesity.
1. Office Furniture and Layout
Providing comfortable, durable, and appropriately sized seating is essential. Standard chairs with armrests can be restrictive for patients with obesity, potentially causing discomfort or embarrassment. Consider the following for a more welcoming environment:
- Furniture: Opt for sturdy chairs without armrests and reinforced benches capable of supporting higher weights. Arrange seating with ample space between chairs to ensure privacy and comfort.
- Exam Tables and Scales: Ensure exam tables are bariatric-rated and capable of supporting a variety of body sizes. Scales should also be capable of accurately measuring higher weights and be located in a private area to maintain patient dignity.
- Accessible Equipment: Other equipment, such as blood pressure cuffs, should come in a variety of sizes. Stocking bariatric gowns and using larger blood pressure cuffs ensures patients do not feel physically uncomfortable or singled out due to their body size.
2. Patient-First Language
The language used to discuss obesity can significantly impact patient comfort and trust. Patient-first language emphasizes the person before the condition, promoting respect and compassion. Rather than saying “obese patient,” say “patient with obesity.” This subtle shift helps reduce the stigma often associated with obesity and underscores the medical nature of the condition rather than placing blame on the individual.
Effective Communication Tips:
- Avoid Judgmental Terms: Avoid terms like “morbid obesity” or “fat,” which can have negative connotations. Instead, ask patients how they prefer to discuss weight and use terms that are non-judgmental and respectful.
- Use Empathetic Language: Engage in conversations that prioritize empathy and understanding. For example, rather than saying “You need to lose weight,” frame it as “Let’s discuss ways to support your health goals.”
- Practice Motivational Interviewing: Utilize motivational interviewing techniques to empower patients, helping them identify their own goals and the steps they are ready to take towards achieving them.
3. Curating Office Reading Materials
Waiting room materials, such as magazines and posters, should reflect a range of body types and focus on overall wellness rather than solely on weight loss. Magazines and brochures featuring average-sized or diverse bodies signal to patients that your practice values health in all forms. Additionally, removing or minimizing weight-loss advertisements and fitness magazines reduces the risk of triggering negative emotions or feelings of inadequacy.
Suggested Reading and Resources:
- Body-Positive Publications: Include magazines that promote body positivity and health at every size, avoiding publications that focus on dieting or “ideal” body shapes.
- Educational Brochures: Provide brochures that educate on the medical aspects of obesity, treatments, and overall health improvement strategies rather than just weight reduction.
4. Staff Training on Sensitivity and Bias
It’s essential for all staff, including receptionists, nurses, and medical assistants, to undergo sensitivity training on obesity and weight bias. Staff should be trained to understand the complexities of obesity as a chronic disease and the importance of treating all patients with dignity and respect. This training can also include strategies for recognizing and addressing any unconscious biases that may affect patient interactions.
Staff Training Tips:
- Annual Bias Training: Hold annual training sessions that cover topics like weight bias, cultural sensitivity, and effective communication strategies.
- Role-Playing Scenarios: Incorporate role-playing exercises to help staff practice empathetic language and responses to common patient concerns.
- Use of Reflective Practices: Encourage staff to reflect on their own biases and how these might impact their interactions with patients. Tools like the Implicit Association Test can help identify areas where bias may exist.
5. Privacy and Comfort During Appointments
Patients with obesity may feel uncomfortable or self-conscious during certain medical procedures, particularly those involving exposure or physical examination. Providing patients with a private and respectful experience helps to alleviate anxiety and promote a trusting provider-patient relationship.
- Privacy for Weighing: Position scales in private areas, out of view from other patients, and only weigh patients when it is medically necessary.
- Respectful Examination Practices: Use bariatric-appropriate gowns and ensure that patients feel comfortable and unhurried during their examinations.
- Comfortable Exam Settings: Be aware of patient comfort, especially during procedures that may involve sensitive areas. Explain procedures clearly and ensure patients feel empowered to voice any discomfort.
By making these changes, you can create an inclusive, respectful environment that fosters trust and encourages patients with obesity to seek care. For clinicians who find it challenging to implement these changes within their practice, partnering with or referring patients to specialists who prioritize comprehensive, compassionate obesity care may be the best approach. Together, we can reduce weight stigma in healthcare and provide better, more effective care for patients with obesity.