P e r s o n - F i r s t Trea t m e n t

Strategies
Weight Bias and Impact on Mental Health of
People Living with Obesity

Nina Crowley, PhD, RD*

KEYWORDS
 Obesity  Weight bias  Stigma  Person-first language  Mental health

KEY POINTS
 Internalizing weight bias significantly and independently contributes to poor emotional
health beyond the impact of body mass index (BMI) or excess weight.
 Health care providers can be inadvertently contributing to further bias and health care
avoidance among their patients if they are not aware of subtle ways their communication
and language can stigmatize.
 Person-first language is one of many strategies to show respect for patients and build a
trusting relationship that will promote adherence to treatment and better outcomes for
both patient and provider.
 Weight bias can be measured and there are strategies to reduce its impact through
assessment, education, communication strategies, language choice, intentional clinical
environment design, and advocacy.

INTRODUCTION
Nature of the Problem: Obesity and Weight Stigma
At this point in time, most Americans are carrying excess weight and are considered
as having the chronic disease of obesity or pre-obesity/overweight and are at risk for
development of weight-related health problems such as type 2 diabetes and cardio-
vascular disease. Despite associations with morbidity, mortality, and psychosocial im-
plications, our society has not yet addressed treatment or prevention from a systemic
perspective. From a public health perspective, it is perplexing to have a majority living
with a chronic health condition and have minimal commitment to prevention, treat-
ment, or policy addressing the condition. Paradoxically, people who have obesity
are also likely to internalize weight bias and harbor bias toward other people with
the same condition.

Medical Body Composition for Seca Corporation

* 1463 Longpsur Drive, Mt Pleasant, SC 29466.
E-mail address: ninamcrowley@gmail.com

Prim Care Clin Office Pract 50 (2023) 89–101

https://doi.org/10.1016/j.pop.2022.10.002 primarycare.theclinics.com
0095-4543/23/ª 2022 Elsevier Inc. All rights reserved.