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saucywench
This is from WebMD's Medscape blog. Many of the doctors who left responses were quite empathetic, while some of them (no surprise) 
were absolute assholes. If you're interested in reading the responses, go to
http://www.medscape.com/public/blogs and scroll down to Public Health & Prevention.
P.S. This might get moved to the health board but seems like it belongs here.
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Sizable Issues
Does Stigma Motivate Weight Loss? The Science Says "No"
Posted By: rebecca puhl, , 12:56PM Jul 7
When giving lectures and seminars to health care professionals on the topic of weight stigma, I am sometimes asked the question, Could stigma be helpful in motivating people to lose weight? In response to this question, I often describe the mounting evidence demonstrating that weight bias may actually contribute to obesity through unhealthy eating behaviors and avoidance of physical activity, which are common coping strategies used by obese children and adults to cope with negative experiences of stigma and prejudice (1,2). From my own experience as a clinical psychologist treating obese patients, the thought of inducing stigma in patients as a way to provide incentive or motivation to lose weight seems unfathomable as an appropriate or ethical treatment approach.
To be fair though, the issue of whether stigma might serve as a tool to facilitate weight loss outcomes is an empirical question and one that, until recently, hadnt really been tested. But two studies were recently published in Annals of Behavioral Medicine, each which approached this issue differently, but both help to challenge this assumption and demonstrate the importance being sensitive to the issue of weight bias as providers counseling patients to lose weight.
The first is a study by Carels and colleagues(3) who studied a sample of overweight/obese treatment-seeking adults participating in a behavioral weight loss program. The authors examined the relationship between patients reported weight bias and (a) program attrition, (b) weight loss, (c) self-monitoring adherence, (d) daily exercise levels and overall caloric expenditure, (e) daily caloric intake, and (f) daily caloric deficit. The authors found that greater weight bias was associated with inconsistent self-monitoring, greater caloric intake, lower energy expenditure and exercise, higher program attrition, and a smaller percentage of weight loss. The study provides some of the first evidence that weight bias can interfere with patients ability to achieve optimal health through weight loss efforts.
The second study is a randomized treatment study by Lillis and colleagues (4), which showed that, compared to wait list controls, a brief one-day intervention that taught patients acceptance-based strategies to cope with obesity-related stigma resulted in greater improvements in body mass, quality of life, perceived weight-related stigma, and psychological distress at three-month follow-up. Thus, rather than using stigma as an incentive to lose weight, this study suggests that supporting individuals with adaptive ways to cope with weight stigma can facilitate weight loss outcomes. A model that can reduce the distress associated with stigma while simultaneously empowering weight control efforts seems like a worthwhile treatment approach to pursue.
Together, these studies add to the growing science on this issue and provide additional insight about the negative impact of weight bias on health for obese patients. While the topic of weight bias is unfortunately often ignored in discussions about obesity, my hope is that this evidence can help to dispel damaging assumptions about obese persons, and can promote an accurate understanding of the consequences of weight bias and the importance of approaching this issue with sensitivity in clinical practice.
References cited in this blog:
1. Puhl RM, Heuer CA. Weight bias: A review and update. Obesity 2009; 17: 941-964.
2. Puhl RM, Latner JD. Stigma, obesity, and the health of the nation's children. Psychol Bull 2007;133:557-580
3. Carels RA, Young KM, Coit CB, Harper J, Gumble A, Hobbs MW, et al. Internalized weight stigma and weight loss treatment outcomes in treatment-seeking adults. Ann Beh Med. 2009. In press.
4. Lillis J, Hayes SC, Bunting K, Masuda A. Teaching acceptance and mindfulness to improve the lives of the obese: A preliminary test of a theoretical model. Ann Beh Med 2009;37:58-69.
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About This Blog
Sizable Issues is a blog featuring timely research findings and provocative commentary about the stigma and prejudice related to obesity -- also known as "weight bias" -- and its implications for healthcare and quality of life for people struggling with weight.
were absolute assholes. If you're interested in reading the responses, go to http://www.medscape.com/public/blogs and scroll down to Public Health & Prevention.
P.S. This might get moved to the health board but seems like it belongs here.
----------------------------------------------------------------------
Sizable Issues
Does Stigma Motivate Weight Loss? The Science Says "No"
Posted By: rebecca puhl, , 12:56PM Jul 7
When giving lectures and seminars to health care professionals on the topic of weight stigma, I am sometimes asked the question, Could stigma be helpful in motivating people to lose weight? In response to this question, I often describe the mounting evidence demonstrating that weight bias may actually contribute to obesity through unhealthy eating behaviors and avoidance of physical activity, which are common coping strategies used by obese children and adults to cope with negative experiences of stigma and prejudice (1,2). From my own experience as a clinical psychologist treating obese patients, the thought of inducing stigma in patients as a way to provide incentive or motivation to lose weight seems unfathomable as an appropriate or ethical treatment approach.
To be fair though, the issue of whether stigma might serve as a tool to facilitate weight loss outcomes is an empirical question and one that, until recently, hadnt really been tested. But two studies were recently published in Annals of Behavioral Medicine, each which approached this issue differently, but both help to challenge this assumption and demonstrate the importance being sensitive to the issue of weight bias as providers counseling patients to lose weight.
The first is a study by Carels and colleagues(3) who studied a sample of overweight/obese treatment-seeking adults participating in a behavioral weight loss program. The authors examined the relationship between patients reported weight bias and (a) program attrition, (b) weight loss, (c) self-monitoring adherence, (d) daily exercise levels and overall caloric expenditure, (e) daily caloric intake, and (f) daily caloric deficit. The authors found that greater weight bias was associated with inconsistent self-monitoring, greater caloric intake, lower energy expenditure and exercise, higher program attrition, and a smaller percentage of weight loss. The study provides some of the first evidence that weight bias can interfere with patients ability to achieve optimal health through weight loss efforts.
The second study is a randomized treatment study by Lillis and colleagues (4), which showed that, compared to wait list controls, a brief one-day intervention that taught patients acceptance-based strategies to cope with obesity-related stigma resulted in greater improvements in body mass, quality of life, perceived weight-related stigma, and psychological distress at three-month follow-up. Thus, rather than using stigma as an incentive to lose weight, this study suggests that supporting individuals with adaptive ways to cope with weight stigma can facilitate weight loss outcomes. A model that can reduce the distress associated with stigma while simultaneously empowering weight control efforts seems like a worthwhile treatment approach to pursue.
Together, these studies add to the growing science on this issue and provide additional insight about the negative impact of weight bias on health for obese patients. While the topic of weight bias is unfortunately often ignored in discussions about obesity, my hope is that this evidence can help to dispel damaging assumptions about obese persons, and can promote an accurate understanding of the consequences of weight bias and the importance of approaching this issue with sensitivity in clinical practice.
References cited in this blog:
1. Puhl RM, Heuer CA. Weight bias: A review and update. Obesity 2009; 17: 941-964.
2. Puhl RM, Latner JD. Stigma, obesity, and the health of the nation's children. Psychol Bull 2007;133:557-580
3. Carels RA, Young KM, Coit CB, Harper J, Gumble A, Hobbs MW, et al. Internalized weight stigma and weight loss treatment outcomes in treatment-seeking adults. Ann Beh Med. 2009. In press.
4. Lillis J, Hayes SC, Bunting K, Masuda A. Teaching acceptance and mindfulness to improve the lives of the obese: A preliminary test of a theoretical model. Ann Beh Med 2009;37:58-69.
----------------------------------------------------------------------
About This Blog
Sizable Issues is a blog featuring timely research findings and provocative commentary about the stigma and prejudice related to obesity -- also known as "weight bias" -- and its implications for healthcare and quality of life for people struggling with weight.
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rebecca puhl
Rebecca Puhl, PhD is the Director of Research at the Rudd Center for Food Policy and Obesity at Yale University. She received her PhD in Clinical Psychology from Yale University. As a clinical psychologist, she has treated patients with eating disorders, binge-eating, and obesity. As a Research Scientist, Dr. Puhl has been studying weight bias for ten years, and has published studies on the prevalence and origins of weight stigma, interventions to reduce weight bias, and the impact of weight stigma on emotional and physical health. Dr. Puhl serves as chair of the Weight Bias Task Force of The Obesity Society (TOS), and is an editor of the book Weight Bias: Nature, Extent, and Remedies (Guilford Press, 2005).
