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Search Results for "discrimination"

Canadians Widely Support Policies and Legal Protection Agains Weight Discrimination

According to a four-country survey published by Rebecca Puhl and colleagues in the Milbank Quarterly,  a representative proportion of the public in Canada, USA, Iceland and Australia, where weight-based discrimination is widely documented would support policies and legal protections against this practice. The survey assessed public support for potential laws to prohibit weight-based discrimination, such as adding body weight to existing civil rights statutes, extending disability protections to persons with obesity, and instituting legal measures to prohibit employers from discriminating against employees because of body weight. At least two-thirds of the participants in all 4 countries expressed support for policies that would make it illegal for employers to refuse to hire, assign lower wages, deny promotions, or terminate qualified employees because of body weight. Women and participants with higher body weight expressed more support for antidiscrimination measures. Here is what Canadians had to say about these issues: Canadians expressed more support for all the proposed laws against weight-based discrimination than did the participants in both Iceland and the United States. 70% to 91% of participants in Canada, US, and Iceland supported laws that would make it illegal for employers to refuse to hire, assign lower wages, deny promotion, or terminate qualified employees because of their body weight. Support was highest for laws that would prohibit employers from assigning lower wages to qualified employees because of their weight. The majority of participants (both adult and student samples) in the United States, Canada, and Australia agreed that their government should have specific laws prohibiting weight discrimination, and they supported laws that would include body weight in existing human rights statutes. 71% to 87% of adults and 69% to 93% of students in all the countries in our study were in favour of passing laws to address bullying in the workplace. laws that would consider obesity as a disability or would provide people with obesity the same legal protections afforded to individuals with physical disabilities received the least support of all laws women were significantly more likely to support antidiscrimination measures than men were support for laws across countries was higher among participants in the obese BMI range than among thinner individuals Beliefs that obesity is caused by factors outside of personal control, such as physiological and environmental factors, were particularly related to increased support for laws In Canada only, beliefs in psychological causes of obesity were positively associated with greater support for laws Certainly enough… Read More »

Information On The Genetic Nature of Obesity Can Reduce Perceived Weight Discrimination and Increase Willingness to Eat Healthier

Continuing the theme of harmful effects of weight bias, a paper by Janine Beekman and colleagues published in Psychology & Health, suggests that providing patients information on the strong genetic nature of obesity may not only reduce perceived weight bias but also increase willingness to eat a healthier diet. In this study 201 women with overweight or obesity aged 20-50 were allowed to interact with a virtual physician in a simulated clinical primary care environment, which included physician-delivered information that emphasized either genomic or behavioral underpinnings of weight and weight loss. This research builds on previous evidence that provision of genomic information in a primary care context can reduce patients’ perceived stigma because they feel less blamed for their weight. As the authors note, “This relates to attribution theory, which posits that causal attributions play an important role in determining reactions to stigmatizing information. The more overweight is attributed to controllable causes (like diet and exercise), the more negative one’s reactions are to it.” All aspects of the virtual encounter were identical except for the type of information given: Participants who received genomic information were told that body weight has a sizeable heritable component, and this may be relevant to their personal situation. Participants who received behavioral information were given a parallel message that it may be harder for those who are already overweight to lose weight (but with no mention of the role of genomics). Both groups were reminded of the importance of health-promoting behaviours related to physical activity and nutrition. After controlling for BMI and race, participants who received genomic information stated that they perceived less blame from the doctor than participants who received behavioral information. In a serial multiple mediation model, reduced perceived blame was significantly associated with less perceived discrimination, and in turn, lower willingness to eat unhealthy foods. Thus, “Providing patients with information about genomics and weight management reduced the extent to which they felt blamed for their weight, when compared to more traditional behavior-based information. Women who felt less blamed for their weight also felt less discriminated against based on their weight, and this reduced perceived discrimination was related to healthier eating and drinking cognitions” These findings may not just have implications for clinical practice but also for public health messages about obesity: “The proliferation of the “war on obesity” and social messages targeted at combating obesity are an attempt to tackle a public health problem… Read More »

Does Weight Discrimination Kill?

The Canadian Obesity Network’s new supportive logo, tagline (respect.knowledge.action) and strategic objective (to remove the stigma from obesity and bring positivity and respect to those who are affected by it) is based on the accumulating evidence that weight bias and discrimination have significant detrimental physical, emotional and social consequences for Canadians living with obesity. Now a paper by Angelina Sutin and colleagues, published in Psychological Science shows a positive association between weight discrimination and the risk of all-cause mortality. The researchers studied almost 20,000 Participants in the Health and Retirement Study (HRS) and the Midlife in the United States Study (MIDUS). In both studies, perceived weight discrimination was associated with an almost 60% increase in mortality risk. This increased risk was not accounted for by common physical and psychological risk factors including BMI, subjective health, disease burden, depressive symptoms, smoking history, and physical activity. The association between mortality and weight discrimination was generally stronger than that between mortality and other attributions for discrimination (e.g. gender, age, sexual orientation, physical disability or “ancestry or national origin” ). Thus, although such studies cannot prove causality, they do suggest that experiencing weight-based discrimination may not only have negative physical, emotional and social consequences for people living with obesity, but may also shorten life. @DrSharma Berlin, Germany

Is Not Calling Obesity A Disease Discrimination?

In the many discussions I have had about calling obesity a disease, I have often heard the argument that calling obesity a disease somehow discriminates against larger people. Indeed, there are people who consider “obesity” to be largely a “social construct” invented by the “medical establishment” to “medicalize” something that is simply a natural part of the spectrum of human shape and size. Funnily enough, some of the most passionate opposition to calling obesity a disease, comes from that very same “medical establishment” – doctors who don’t want to see providing obesity care as part of their job, hospital administrators who think providing obesity treatments takes resources away from dealing with “real” diseases, and payers who fear having to shell out millions of dollars for expensive obesity treatments. Indeed, if I had to point to one single factor that has in fact stopped the “medical establishment” from finding better treatments and providing access to effective and compassionate care for people struggling with excess weight, it is their refusal to consider obesity a disease. The paradox in all this would be funny if it were not so sad – it turns out that many in the very same “medical establishment” that is being sharply criticized by social scientists and the size-acceptance crowd for “medicalizing” obesity, are in fact fighting as hard as they possibly can to NOT have obesity declared a disease. So oddly, the people who appear so concerned that labeling obesity a disease could somehow discriminate against people of size,  are widely supported by the general public, many of who would think the notion of obesity as a disease ridiculous, given that in their view, being large is simply a matter of poor choices.  Sounds to me, like a rather uncanny alliance between the far left and the far right. While I fully understand that for some people, being “labeled” as having a disease may be traumatic, I see this as no more or less traumatic than being “labeled” as having hypertension, diabetes, arthritis, sleep apnea, or for that matter, cancer. Does this mean some people for who their excess weight poses no medical risk will get mislabeled? Sure it does. But there are also many otherwise healthy folks “labeled” as having hypertension, diabetes or even cancer, who will live to a ripe old age – good for them! I am also the first to celebrate size and shape diversity and readers may recall that I invented the Edmonton Obesity Staging System to deal with the issue of “healthy”… Read More »

Are Cost-Saving Arguments For Treating Obesity Another Form of Discrimination?

Yes, health care costs consume an increasing proportion of taxes (in countries with public healthcare systems) or personal income. Yes, there is also considerable waste in healthcare systems and not every dollar spent is necessary or provides any meaningful benefit. Indeed, even where health benefits are achieved, these may perhaps be had at a lower cost than in our current systems. Thus, there is no argument against reducing waste and improving cost-effectiveness of treatments (or for that matter, prevention). However, arguing in favour of cost-effectiveness should not be confused with arguments for cost-savings, as is often put forward in discussions about obesity treatment. Indeed, authors often bend over backwards to demonstrate the potential cost-savings that may come from treating obesity. Case in point is a study by Oleg Borisenko and colleagues, who in a paper published in Obesity Surgery, suggest that (based on the Scandinavian Bariatric Surgery Registry), surgical treatment of severe obesity led to savings of €8408 per patient, which translates into lifetime savings savings of €66 million for the cohort, operated in 2012. Be that as it may, I feel that savings cannot be the sole argument in favour of providing treatments for a disease. Given the tremendous impact that obesity has on the health and lives of people living with obesity, I would argue for treatments even if they increase healthcare costs. Let us remind ourselves that we do not argue about whether or not treating people with heart attacks, osteoarthritis, kidney failure or cancer saves money for the health care system – it rarely does, and is besides the point. The reason we spend money treating these conditions is because the people presenting with these conditions deserve treatment – period! Thus, I would argue that the primary reason that health care systems should be spending money on treating obesity is because people with obesity deserve treatment – not because it saves money for the system. Thus, even if there was a net cost to treating obesity, people with obesity deserve treatment as much as people with diabetes, heart disease or chronic kidney disease. If this means a greater cost to the health care system, so be it – raise taxes or increase payers contributions – don’t try to save money by simply refusing to pay for obesity treatment (or rationing it by making it difficult for patients to access). Using cost-savings as the prime argument for treating obesity… Read More »