Nature vs. Nurture: The Weight Discussion with Patients

Some researchers (Toniyama, 2014) have proposed that weight-based discrimination is a positive feedback loop in which “weight stigma begets weight gain”, and patients classified as overweight and obese may experience discrimination from a variety of sources (… health care professionals included).


In a recent study, Beekman et al. (2015) sought out to determine if female adults perceived more blame and weight discrimination from a virtual physician if genomic (e.g., genetics) or behavioral (e.g., physical activity, diet) underpinnings of weight were discussed. The authors reported that participants who were provided genomic information (vs. behavioral) perceived less blame and discrimination, which may be positively associated with enhanced willingness to engage in healthy lifestyle behaviors.

Although it’s not surprising that patients may perceive more blame regarding the discussion of what they can (i.e., behavior) vs. what they cannot (i.e., genetics) control , I do believe that striking a balance between the two is essential; while a patient may perceive a patient-physician conversation solely focused on behavior to be stigmatizing, a conversation pertaining only to genetics may not sufficiently encourage a patient towards positive behavior change if the issue is perceived as being “out of their control”.


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