Assistant Professor Kiki Fornero hopes to improve healthcare by reducing weight stigma
By Mercedes Rose
Old Navy has eliminated its separate women’s plus-size section. Celebrities like Lizzo and Ashley Graham are unapologetically showing their followers how to embrace a healthy lifestyle regardless of weight. Yet, says Linfield-Good Samaritan School of Nursing Assistant Professor Kiki Fornero, the medical community continues to struggle with how to balance the growing acceptance of body positivity with patient healthcare.
Fornero hopes to help others look past weight when it comes to care. She is finishing her doctorate in nursing from Oregon Health & Science University this spring, with a dissertation titled, “Weight Stigma Narratives for Individuals with Depression After Bariatric Surgery.” Her research explores the effects of weight stigma on a patient’s mental health and how that can compromise care.
Weight stigma – that is, discriminatory actions or beliefs towards individuals because of their weight and size – can occur nearly anywhere, including in workplaces, social media and healthcare settings. The World Health Organization notes that 69% of obese adults report experiences of stigmatization from healthcare professionals. For patients, this experience can have negative effects on patients’ physical and mental health.
Q: How would you describe your research?
My research explores people’s experiences of weight stigma. More specifically, I am examining the cumulative effect on a person’s mental health when they have been discriminated against because of body size or weight. My dissertation has a special focus on people who have had weight-loss surgery and how they perceived weight stigma afterward.
Q: Why is this research important?
For decades, nurses have been taught that body size is a risk factor, and it’s still that way. The research supporting this is messy because body size is one indicator; however, there are things like childhood trauma or stress level, among others, that impact our health. But, so often, everything gets attributed to body size.
When this happens, conditions can be overlooked or treated improperly.
In addition, negative interactions with healthcare providers often lead people to avoid seeking care. If a patient feels stigmatized by their nurse or doctor, they will be less inclined to get help when needed. This leads to diseases or conditions being much more advanced when they do eventually seek care, leading to poorer overall health outcomes.
Q: What is being done to reduce weight stigma in clinical care settings?
Changes are slowly being made. Waiting rooms are starting to have different types of seating, so that all bodies have a comfortable option. Larger gowns and blood pressure cuffs are being stocked in examination rooms, so that nurses don’t have to track down a larger size during an exam.
The concept of weight neutrality is starting to emerge in healthcare education. This approach to care focuses goals for health on things other than weight. Examples of this are a patient increasing their fitness level to keep up with family, lowering their cholesterol or blood pressure, or eating better to get off blood sugar medicine, among others.
As a patient, it’s also becoming increasingly okay to tell the doctor that you don’t want to be weighed. (Although, you can expect that they might push back on that because it’s such an ingrained part of the system to put the number on your chart.)
Q: How do you hope your research will be applied at Linfield?
As a nurse educator, I really want to practice what I preach. This includes talking to students more about weight-neutral approaches to care because it’s not currently in nursing curricula. There is no literature about it. And it’s not specific to Linfield. I hope to provide a more complete educational experience for our students by embedding the concept of weight neutrality into the curriculum. After I wrap up this dissertation, I want to really look at our coursework and see how we, as educators, can expose students more to the idea that we can support patient health without telling people with larger body sizes that they need to lose weight.
