An Association Between Provider Stigma and Metabolically Healthy Obese Patient Outcomes: An Integrative Literature Review

Abstract

Background: Provider stigmatization of obese patients, whether they are metabolically healthy (MHO) or not, is a well-known issue in the healthcare system.

Objectives: The purpose of this study is to examine the reasons for weight stigma among providers as well as to identify the effect of the stigma on outcomes and goals for MHO patients, since these have not been previously explored.

Method: The study is an integrative literature review, guided by the Interaction Model of Client Health Behavior (IMCHB) framework, as well as the Whittemore and Knafl method for analyzing research via a chart matrix. A search was conducted of CINAHL, PsycInfo, PubMed, and ProQuest Nursing & Allied Health Database. The keywords searched included “obesity” and “bias or stigma” and “health personnel or practitioner” and “psych”.

Results: Ten studies met the research criteria for review using the inclusion and exclusion criteria. The results obtained showed that the reasons for provider stigma included a deficient education, an inability to see the patient as a collaborator in care, and an inconsideration of the patient’s culture and lifestyle. When stigma was perceived by the patient, negative outcomes occurred; however, not all patients perceived a stigma from their providers.

Conclusion: The implications for nursing in this study are extensive and involve learning more about the obese population in general and specifically about MHO patients. Advocating for these patients through legislation and intervention education for healthcare teams are important roles for nurses. Future research should focus on educational methods for obese patients and specific interventions for MHO patients.

Key words: obesity, bias, stigma, health personnel, practitioner, psych