Weight Bias: A Narrative Review of the Evidence, Assumptions, Assessment, and Recommendations for Weight Bias in Health Care

Abstract

Background Weight bias is common in health care and needs to be addressed to provide equal and equitable care for people of all body sizes. Aims This review aims to (a) describe the impact of weight bias on providers and patients, (b) identify the limitations of body mass index and suggest alternative screenings to determine health risk, (c) provide a review of self-assessment of weight bias, and (d) present evidence of an alternative weight-inclusive approach to health care. Method EBSCO Host, Google Scholar, and Pubmed were used to find peer reviewed articles. Keywords included the following: weight bias, weight stigma, weight inclusive, and weight discrimination. Results Projected weight bias is prevalent among health care providers and affects patient visit times, care provided, and communication given. Patients who experience weight bias are more likely to experience stress and depression, which impact chronic disease risk. Body mass index was also found to have numerous limitations as a metric for identifying accurately an individual’s cardiometabolic risks, whereas, waist-to-height ratio is a more accurate indicator. There are also numerous screening tools that are available to self-assess for weight bias although more studies are needed to standardize results. An alternative approach to combat weight bias is a behavior-focused approach on health as opposed to weight-focused. Conclusion Weight bias is a critical topic that health professionals need to consider to be aware of and begin to change as it has a strong impact on the public’s health.