Viés de peso entre os nutricionistas: o status do peso dos pacientes altera as abordagens dietéticas?

Autores

Palavras-chave:

Nutricionistas, Obesidade, Estereotipagem, Preconceito de Peso

Resumo

Objetivo
Visto que a obesidade é uma doença multifatorial, alguns profissionais de saúde podem defender que o controle de peso é uma questão de força de vontade pessoal e estigmatizam os indivíduos. Essas atitudes baseadas no peso parecem bastante comuns mesmo entre os nutricionistas. Este estudo teve como objetivo determinar se o nível de viés de peso afeta as abordagens dietéticas dos nutricionistas. 
Métodos
Dois casos hipotéticos com vinhetas de obesidade e peso normal foram criados para serem avaliados e o viés de peso explícito foi avaliado pela escala de fobia de gordura Fat Phobia Scale entre 99 nutricionistas por meio de um questionário online.
Resultados
A maioria dos nutricionistas demonstrou níveis leves ou moderados de viés de peso (59,6% e 32,3%, respectivamente). A vinheta de obesidade teve a maior concordância pela maioria e foi percebida como tendo a pior qualidade da dieta, o pior estado geral de saúde, e níveis de atividade física insuficientes.
Conclusão
Em suma, sendo esta uma questão que preocupa a maior parte dos nutricionistas e um problema que continua a afetar tantas pessoas, é urgente a criação de medidas que permitam diminuir o preconceito e proteger os pacientes de atitudes estigmatizantes.

Referências

Meldrum DR, Morris MA, Gambone JC. Obesity pandemic: causes, consequences, and solutions - but do we have the will? Fertility and Sterility. 2017;107(4):833-39. https://doi.org/10.1016/j.fertnstert.2017.02.104

Gadde KM, Martin KC, Berthoud H-R, Heymsfield, Steven B. Obesity: pathophysiology and Management. J Am Coll Cardiol. 2018;71(1):69-84. https://doi.org/10.1016/j.jacc.2017.11.011

Ohen R, Shikora S. Fighting weight bias and obesity stigma: a call for action. Obes Surg. 2020;30(7):1623-24. https://doi.org/10.1007/s11695-020-04525-0

Harvey EL, Summerbell CD, Kirk SFL, Hill AJ. Dietitians’ views of overweight and obese people and reported management practices. J Hum Nutr Diet. 2002;15(5):331-47. https://doi.org/10.1046/j.1365-277X.2002.00385

Jung FUCE, Luck-Sikorski C, Wiemers N, Riedel-Heller SG. Dietitians and nutritionists: Stigma in the context of obesity. A systematic review. Plos one. 2015;10(10):e0140276. https://doi.org/10.1371/journal.pone.0140276

Puhl RM, Brownell KD. Confronting and coping with weight stigma: an investigation of overweight and obese adults. Obesity. 2006;14(10):1802-15. https://doi.org/10.1038/oby.20006.28

Stone O, Werner P. Israeli dietitians’ professional stigma attached to obese patients. Qual Health Res. 2012;22(6):768-76. https://doi.org/10.1177/1049732311431942

Wu YK, Berry DC. Impact of weight stigma on physiological and psychological health outcomes for overweight and obese adults: a systematic review. J Adv Nursing. 2018;74(5):1030-42. https://doi.org/10.1111/jan.13511

Alberga AS, Russell-Mayhew S, von Ranson KM, McLaren L, Ramos Salas X, Sharma AM. Future research in weight bias: What next? Obesity. 2016;24(6):1207-9. https://doi.org/doi:10.1002/oby.21480

Puhl RM, Andreyeva T, Brownell KD. Perceptions of weight discrimination: prevalence and comparison to race and gender discrimination in America. Int J Obes. 2008;32(6):992-1000. https://doi.org/10.1038/ijo.2008.22

Puhl R, Suh Y. Health Consequences of weight stigma: implications for obesity prevention and treatment. Curr Obes Rep. 2015;4(2):182-90. https://doi.org/10.1007/s13679-015-0153-z

Alberga AS, Pickering BJ, Alix Hayden K, Ball GDC, Edwards A, Jelinski S, et al. Weight bias reduction in health professionals: a systematic review. Clin Obes. 2016;6(3):175-88. https://doi.org/10.1111/cob.12147

Panza GA, Armstrong LE, Taylor BA, Puhl RM, Livingston J, Pescatello LS. Weight bias among exercise and nutrition professionals: a systematic review. Obesity Reviews. 2018;19:1492-1503. https://doi.org/10.1111/obr.12743

World Health Organization. Weight bias and obesity stigma: considerations for the WHO European Region. Copenhagen: Organization; 2018 [cited 30 Apr 2021]. Available from: https://www.euro.who.int/__data/assets/pdf_file/0017/351026/WeightBias.pdf

Berryman DE, Dubale GM, Manchester DS, Mittelstaedt R. Dietetics students possess negative attitudes toward obesity similar to nondietetics students. J Am Diet Assoc. 2006;106(10):1678-82. https://doi.org/10.1016/j.jada.2006.07.016

Pearl RL, Wadden TA, Shaw Tronieri J, Chao AM, Alamuddin N, Bakizada ZM, et al. Sociocultural and familial factors associated with weight bias internalization. Obes Facts. 2018;11(2):157-164. https://doi.org/10.1159/000488534

Pudney E V, Himmelstein MS, Puhl RM, Foster GD. Distressed or not distressed? A mixed methods examination of reactions to weight stigma and implications for emotional wellbeing and internalized weight bias. Soc Sci Med. 2020;112854. https://doi.org/10.1016/j.socscimed.2020.112854

Puhl RM, Heuer CA. Obesity stigma: important considerations for public health. Am J Public Health. 2010;100(6):1019-28. https://doi.org/10.2105/AJPH.2009.159491

Edelstein S, Gillis N. Obesity bias among dietitians by using the fat people-thin people implicit association test. J Am Diet Assoc. 2008;108(9):A40. https://doi.org/10.1016/j.jada.2008.06.418

Puhl R, Wharton C, Heuer C. Weight Bias among dietetics students: implications for treatment practices. J Am Diet Assoc. 2009;109(3):438-44. https://doi.org/10.1016/j.jada.2008.11.034

Swift JA, Hanlon S, El-Redy L, Puhl RM, Glazebrook C. Weight bias among UK trainee dietitians, doctors, nurses and nutritionists. J Hum Nutr Diet. 2013;26(4):395-402. https://doi.org/10.1111/jhn.12019

Cori GC, Petty MLB, Alvarenga M S. Attitudes of dietitians in relation to obese individuals – An exploratory study. Cienc e Saude Coletiva. 2015;20(2):565-76. https://doi.org/10.1590/1413-81232015202.05832014

Hellbardt M, Riedel-heller SG, Sikorski C. Dietitians’ attitudes towards obese patients. Ernährungs Umschau. 2014;61(5):78-81. https://doi.org/10.4455/eu.2014.015

Diversi TM, Hughes R, Burke KJ. The prevalence and practice impact of weight bias amongst Australian dietitians. Obes Sci Pract. 2016;2(4):456-65. https://doi.org/10.1002/osp4.83

Robinson BBE, Bacon LC, O’reilly J. Fat phobia: measuring, understanding, and changing anti-fat attitudes. Int J Eat Disord. 1993;14(4):467-80. https://doi.org/10.1002/1098-108X(199312)14:4<467::AID-EAT2260140410>3.0.CO;2-J

Bacon JG, Scheltema KE, Robinson BE. Fat phobia scale revisited: the short form. Int J Obes. 2001;25:252-7. 10.1038/sj.ijo.0801537

Koçak S, Saraç L, Hürmeriç I. Determining the relationships among body mass index, body composition and attitudes toward fat people. Proceedings of the ICHPER-SD Annivarsary World Congress. International Council for Health, Physical Education, Recreation, Sport and Dance. İstanbul, Turkey; 2005.

McClure KJ, Puhl RM, Heuer CA. Obesity in the news: do photographic images of obese persons influence antifat attitudes? J Health Commun. 2011;16(4):359-71. https://doi.org/10.1080/10810730.2010.535108.

Sikorski C, Luppa M, Glaesmer H, Brähler E, König HH, Riedel-Heller SG. Attitudes of health care professionals towards female obese patients. Obes Facts. 2013;6(6):512-22. https://doi.org/10.1159/000356692

Obara AA, Vivolo SRGF, Alvarenga MDS. Weight bias in nutritional practice: a study with nutrition students. Cad Saude Publica. 2018;34(8):e00088017. https://doi.org/10.1590/0102-311x00088017

Suchy FJ, Brannon PM, Carpenter TO, Fernandez JR, Gilsanz V, Gould JB, et al. National Institutes of Health Consensus Development Conference: lactose intolerance and health. Ann Intern Med. 2010;152(12):792-96. https://doi.org/10.7326/0003-4819-152-12-201006150-00248

Bacardí-Gascón M, Jimenéz-Cruz A, Castillo-Ruiz O, Bezares-Sarmiento V, León-González JM. Fat phobia in Mexican nutrition students. Nutr Hosp. 2015;32(6):2956-7. https://doi.org/10.3305/nh.2015.32.6.9812

Hayran O, Akan H, Özkan AD, Kocaoǧlu B. Fat Phobia of university students: attitudes toward obesity. J Allied Health. 2013;42(3):147-50.

Puhl RM, Latner JD, King KM, Luedicke J. Weight bias among professionals treating eating disorders: attitudes about treatment and perceived patient outcomes. Int J Eat Disord. 2014;47(1):65-75. https://doi.org/10.1002/eat.22186

Schwartz MB, Chambliss HON, Brownell KD, Blair SN, Billington C. Weight Bias among Health Professionals Specializing in Obesity. Obes Res. 2003;11(9):1033-9. https://doi.org/10.1038/oby.2003.142.

Crandall CS, Reser AH. Attributions and Weight-Based Prejudice. In: Kelly DB, Puhl RM, Schwartz MB, Rudd L, editors. Weight bias: Nature, consequences, and remedies. New York: Guilford Publications; 2005. p.83-96.

Raynor HA, Champagne CM. Position of the academy of nutrition and dietetics: interventions for the treatment of overweight and obesity in adults. J Acad Nutr Diet. 2016;116(1):129-47. https://doi.org/10.1016/j.jand.2015.10.031

Phelan SM, Burgess DJ, Yeazel MW, Hellerstedt WL, Griffin JM, van Ryn M. Impact of weight bias and stigma on quality of care and outcomes for patients with obesity. Obes Rev. 2015;16(4):319-26. https://doi.org/10.1111/obr.12266

Dağ A, Çakır B, Kılınç FN, Türkmen EG. General profile and job satisfaction of Turkish dietitians. Prog Nutr. 2019;21(3):531-6. https://doi.org/10.23751/pn.v21i3.7792

Atayata F. TURKEY Information Sheet: ©International Affiliate of the Academy of Nutrition and Dietetics 2018. Ankara; 2019 [cited 31 May 2022]. Available from: https://eatrightinternational.org/wp-content/uploads/2019/05/turkey-cis-2018-edited-2019.pdf

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Publicado

06-03-2023

Como Citar

KAYA CEBIOĞLU, İrem, DUMLU BILGIN, G., OKAN BAKIR, B., & GÜL KOYUNCU, A. (2023). Viés de peso entre os nutricionistas: o status do peso dos pacientes altera as abordagens dietéticas?. Revista De Nutrição, 35, 1–9. Recuperado de https://seer.sis.puc-campinas.edu.br/nutricao/article/view/7566

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ARTIGOS ORIGINAIS