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Policies and training

Оглавление

In addition to legislative actions, workplaces can adopt their own institutional policies and training initiatives to prevent weight‐based discrimination and stigmatization. For example, hiring practices can use blinded review of candidates when possible and focus on objective criteria for evaluation [16]. Experts have also recommended the inclusion of weight in workplace diversity, discrimination, and harassment training [130], a practice that is strongly supported by people with obesity [120]. Data from the MIDUS survey showed that the effects of obesity on chronic job discrimination were mitigated when individuals endorsed having supervisor or coworker support [131]. This finding highlights the importance of creating an inclusive work environment from the top down.

Educational institutions and professionals may also benefit from greater attention to weight in anti‐bullying curricula and teacher training. In a study that reviewed 275 published anti‐bullying interventions from 1966 to 2013, not a single intervention focused specifically on weight‐based bullying [132]. The public, educators, and parents strongly support school‐based policies to prevent weight‐based bullying [126–128]. The majority of adolescents also report a preference for classroom teachers to intervene with weight‐based peer victimization, particularly adolescents who experience frequent victimization [12]. Additional training for teachers may be needed to help implement these initiatives [126]. This may be particularly important for educators who are likely to witness or be informed of weight‐based bullying, such as PE teachers, school nurses and counselors, and educators who deliver obesity prevention or health‐based curricula [133,134].

Similar to training for educators, weight sensitivity training for health care professionals has the potential to reduce weight stigmatization of patients with obesity [120,135]. Some care units already require such training (e.g. for bariatric care). Considering the high likelihood that most providers will see patients with obesity in their practice, these trainings may be expanded widely throughout hospital systems. More research is needed to identify effective strategies for reducing weight‐biased attitudes and promoting the use of patient‐centered care approaches by health care trainees and professionals in their interactions with patients with obesity [28,135]. The American Board of Obesity Medicine was established to provide more advanced training to health care professionals in obesity treatment [136]. More attention to obesity could be beneficial earlier in training curricula, such as dispelling myths about weight controllability, identifying realistic weight loss goals, and practicing strategies for initiating conversations about weight when appropriate. Health practices can institute other structural policies, such as requiring adequately sized equipment for larger bodies and avoiding the use of stigmatizing medical terms (e.g. “morbid obesity” [137,138]). Finally, health care institutions can prohibit the use of BMI cutoffs as the singular criterion for determining whether or not patients are eligible for certain procedures (e.g. for fertility treatments or orthopedic surgeries), as this practice is discriminatory and often not rooted in evidence‐based practice.

Clinical Obesity in Adults and Children

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