Obesity bias and stigma, attitudes and beliefs among entry-level physiotherapy students in the Republic of Ireland: a cross sectional study

G O’Donoghue,S Mcmahon,A Holt,M Nedai,T Nybo,C.L Peiris

doi:10.1016/j.physio.2021.03.016

G O’Donoghue, S Mcmahon + Show 4 more

Open Access

https://doi.org/10.1016/j.physio.2021.03.016

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Journal: Physiotherapy	Publication Date: Mar 26, 2021
Citations: 6	License type: cc-by

Affiliation: University College Dublin, La Trobe University

Abstract

ObjectiveTo explore entry-level physiotherapy students’ attitudes and beliefs relating to weight bias and stigmatisation in healthcare. DesignCross sectional survey of physiotherapy students. MethodsAll final year physiotherapy students (n = 215) enrolled in entry-level physiotherapy programmes in the Republic of Ireland were invited to participate. Each received a questionnaire, consisting of 72 questions, within four key sections. Descriptive statistics and frequencies were used to analyse the data. ResultsA response rate of 83% (179/215) was achieved. Whilst physiotherapy students, overall, had a positive attitude towards people with obesity, 29% had a negative attitude towards people with obesity, 24% had a negative attitude towards managing this population and most (74%) believed obesity was caused by behavioural and individual factors. Over one third of students (35%) reported that they would not be confident in managing patients with obesity and more than half (54%) felt treating patients with obesity was not worthwhile. ConclusionThis study provides preliminary findings to suggest that weight stigma-reduction efforts are warranted for physiotherapy students. Helping students to understand that obesity is a complex, chronic condition with multiple aspects requiring a multi-faceted approach to its management might be the first step towards dispelling these negative attitudes towards patients living with obesity. Inclusion of a formal obesity curriculum should perhaps now be part of the contemporary physiotherapy students’ education.

Highlights

Despite scientific evidence to the contrary, the prevailing view of healthcare professionals appears to be that obesity is a choice that can be reversed by voluntary decisions to eat less and exercise more [1,2]
These assumptions have been shown to result in multiple negative encounters for patients living with obesity, one of which is experiencing weight bias and stigma at the hands of their healthcare providers [2]
All returned questionnaires were completed in their entirety (n = 179)

Summary

Introduction

Despite scientific evidence to the contrary, the prevailing view of healthcare professionals appears to be that obesity is a choice that can be reversed by voluntary decisions to eat less and exercise more [1,2]. Existing literature reports that physicians and other healthcare professionals perceive people with obesity as undisciplined, lazy, weak-willed and unlikely to comply with treatment or make lifestyle changes [3,4,5]. These assumptions have been shown to result in multiple negative encounters for patients living with obesity, one of which is experiencing weight bias and stigma at the hands of their healthcare providers [2]. A recent systematic review exploring weight stigmatisation in physiotherapy reported explicit weight stigma in six of the seven included studies, with the majority of physiotherapists describing people with increased weight as ‘noncompliant’ and ‘unmotivated’ [14]. In terms of beliefs about obesity, most physiotherapists agree that obesity is a legitimate health issue and that physiotherapy can play a central role in its management through exercise interventions, mobility training and cardiorespiratory programmes for associated impairments [15,16]

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