Are Current Guidelines Perpetuating Weight Stigma? A Weight-Skeptical Approach to the Care of Patients with Obesity.
Scott L HaganKarin NelsonPublished in: Journal of general internal medicine (2022)
Significant controversy exists regarding the evidence to support the clinical benefits and risks of weight loss interventions for individuals with obesity. United States Preventative Task Force (USPSTF) guidelines recommend weight loss for all individuals with obesity while weight-neutral models such as Health at Every Size promote weight inclusivity, focusing on body acceptance rather than weight loss. We discuss how lifestyle-based weight-centric paradigms, such as the USPSTF Guidelines, may increase weight stigma and weight cycling, and many of their purported clinical benefits are not supported by existing evidence. However, we also acknowledge the clear benefits of metabolic surgery in high-risk individuals, and the potential benefits for pharmacotherapy for obesity in selected patients. Herein we describe a weight-skeptical approach to the care of patients with obesity that aims to use available evidence to support patient-centered care.
Keyphrases
- weight loss
- bariatric surgery
- roux en y gastric bypass
- weight gain
- gastric bypass
- healthcare
- mental health
- glycemic control
- palliative care
- physical activity
- metabolic syndrome
- body mass index
- quality improvement
- clinical practice
- minimally invasive
- insulin resistance
- risk assessment
- newly diagnosed
- social media
- pain management
- social support
- hepatitis c virus
- depressive symptoms
- coronary artery disease
- health information
- human health
- body weight
- health insurance
- mental illness
- smoking cessation
- skeletal muscle
- high fat diet induced