Department of Psychology, University of California Los Angeles, 1285 Franz Hall, Los Angeles, CA, 90095, USA.
Department of Sociology, Boston University, Boston, MA, USA.
BMC Med. 2018 Aug 15;16(1):123. doi: 10.1186/s12916-018-1116-5.
In an era when obesity prevalence is high throughout much of the world, there is a correspondingly pervasive and strong culture of weight stigma. For example, representative studies show that some forms of weight discrimination are more prevalent even than discrimination based on race or ethnicity.
In this Opinion article, we review compelling evidence that weight stigma is harmful to health, over and above objective body mass index. Weight stigma is prospectively related to heightened mortality and other chronic diseases and conditions. Most ironically, it actually begets heightened risk of obesity through multiple obesogenic pathways. Weight stigma is particularly prevalent and detrimental in healthcare settings, with documented high levels of 'anti-fat' bias in healthcare providers, patients with obesity receiving poorer care and having worse outcomes, and medical students with obesity reporting high levels of alcohol and substance use to cope with internalized weight stigma. In terms of solutions, the most effective and ethical approaches should be aimed at changing the behaviors and attitudes of those who stigmatize, rather than towards the targets of weight stigma. Medical training must address weight bias, training healthcare professionals about how it is perpetuated and on its potentially harmful effects on their patients.
Weight stigma is likely to drive weight gain and poor health and thus should be eradicated. This effort can begin by training compassionate and knowledgeable healthcare providers who will deliver better care and ultimately lessen the negative effects of weight stigma.
在世界上许多地方肥胖率普遍较高的时代，普遍存在着强烈的体重歧视文化。例如，有代表性的研究表明，一些形式的体重歧视甚至比基于种族或族裔的歧视更为普遍。
在这篇观点文章中，我们回顾了令人信服的证据，表明体重歧视除了与客观体重指数有关外，对健康也是有害的。体重歧视与死亡率升高和其他慢性疾病和状况有关。最具讽刺意味的是，它实际上通过多种肥胖症途径增加了肥胖的风险。体重歧视在医疗保健环境中尤为普遍和有害，有记录表明医疗保健提供者存在高度的“反肥胖”偏见，肥胖患者接受的护理较差，结果更差，而肥胖的医学生报告说，为了应对内化的体重歧视，他们大量饮酒和使用药物。就解决方案而言，最有效和最合乎道德的方法应该针对那些歧视者的行为和态度，而不是针对体重歧视的目标。医学培训必须解决体重偏见问题，培训医疗保健专业人员了解其是如何产生的，以及它对患者可能产生的潜在有害影响。
体重歧视可能会导致体重增加和健康状况不佳，因此应该予以消除。这项工作可以从培训有同情心和知识渊博的医疗保健提供者开始，他们将提供更好的护理，并最终减轻体重歧视的负面影响。
