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      Preconceito relacionado ao peso na conduta nutricional: um estudo com estudantes de nutrição Translated title: Prejuicios relacionados con el peso en la conducta nutricional: un estudio con estudiantes de nutrición Translated title: Weight bias in nutritional practice: a study with nutrition students

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          Abstract

          Resumo: A obesidade está relacionada a problemas psicossociais como estigma, discriminação e preconceito. Estudos verificaram que nutricionistas e estudantes de nutrição apresentam atitudes negativas e preconceito em relação aos indivíduos com obesidade. O estudo avaliou a existência de preconceito em relação aos indivíduos obesos por parte de estudantes de nutrição. Os estudantes responderam aos questionários por meio de preenchimento de formulários on-line - dados demográficos, peso e altura autorreferidos; em seguida foram direcionados para um de quatro casos hipotéticos - sorteados aleatoriamente - de um paciente referenciado a um nutricionista após receber o diagnóstico de intolerância à lactose (sexo masculino e eutrófico; sexo feminino e eutrófica; sexo masculino e obeso; e sexo feminino e obesa). Com exceção do peso, do índice de massa corporal (IMC) e do consumo energético diário, todas as informações relativas à dieta, hábitos de vida e condições de saúde eram idênticas para os perfis do mesmo sexo. Incluíram-se questões relativas à indicação de procedimentos e condutas durante a consulta, tempo de atendimento, estratégias de aconselhamento, avaliação da dieta e da saúde, e reações afetivas e comportamentais. Participaram 335 estudantes, prioritariamente mulheres, com IMC médio de 23kg/m². O peso do paciente influenciou o tempo de atendimento, percepções, condutas e estratégias de tratamento, com a identificação de preconceitos e atitudes negativas principalmente relacionadas às percepções e reações dos estudantes diante dos pacientes com obesidade, sendo que a mulher com obesidade recebeu piores avaliações no geral.

          Translated abstract

          Resumen: La obesidad está relacionada con problemas psicosociales como: estigma, discriminación y prejuicios. Algunos estudios verificaron que nutricionistas y estudiantes de nutrición presentan actitudes negativas y prejuicios, en relación con los individuos con obesidad. El estudio evaluó la existencia de prejuicios, en relación con los individuos obesos, por parte de estudiantes de nutrición. Los estudiantes respondieron los cuestionarios mediante la cumplimentación de formularios on-line - datos demográficos, peso y altura autoinformados; en seguida fueron dirigidos hacia uno de los cuatro casos hipotéticos -sorteados aleatoriamente- de un paciente enviado a un nutricionista, tras recibir el diagnóstico de intolerancia a la lactosa (sexo masculino y eutrófico; sexo femenino y eutrófica; sexo masculino y obeso; y sexo femenino y obesa). Con excepción del peso, del índice de massa corporal (IMC) y del consumo energético diario, toda la información relativa a la dieta, hábitos de vida y condiciones de salud eran idénticas para los perfiles del mismo sexo. Se incluyeron cuestiones relativas a la indicación de procedimientos y conductas durante la consulta, tiempo de atención, estrategias de asesoramiento, evaluación de la dieta y salud, así como reacciones afectivas y comportamentales. Participaron 335 estudiantes, en su mayoría mujeres, con un IMC medio de 23kg/m². El peso del paciente influenció en el tiempo de atención, percepciones, conductas y estrategias de tratamiento, con la identificación de prejuicios y actitudes negativas, principalmente relacionadas con las percepciones y reacciones de los estudiantes ante los pacientes con obesidad, donde las mujeres con obesidad recibieron peores evaluaciones en general.

          Translated abstract

          Abstract: Obesity is associated with psychosocial problems like stigma, discrimination, and bias. Studies have found that nutritionists and nutrition students display negative attitudes and biases toward obese individuals. This study examined the existence of nutrition students’ bias toward obese individuals. The students answered questionnaires by completing on-line forms with demographic data and self-reported weight and height and were assigned to one of four randomly selected hypothetical cases of patients referred to a nutritionist after receiving a diagnosis of lactose intolerance (normal weight man; normal weight woman; obese man; and obese woman). Except for weight, body mass index (BMI), and daily energy intake, all information on diet, habits, and health conditions were identical for profiles of the same sex. The questionnaire included questions on the indication of procedures and approaches during the consultation, consultation time, counseling strategies, dietary and health evaluation, and students’ affective and behavioral reactions. Three hundred and thirty-five students participated, mostly women, with mean BMI of 23kg/m². Patient’s weight influenced consultation time and students’ perceptions and treatment approaches and strategies. The study revealed biases and negative attitudes mainly involving the students’ perceptions and reactions to obese patients, and obese women generally received the worse evaluations.

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          Changes in perceived weight discrimination among Americans, 1995-1996 through 2004-2006.

          Little is known about the prevalence and patterns of weight discrimination in the United States. This study examined the trends in perceived weight/height discrimination among a nationally representative sample of adults aged 35-74 years, comparing experiences of discrimination based on race, age, and gender. Data were from the two waves of the National Survey of Midlife Development in the United States (MIDUS), a survey of community-based English-speaking adults initially in 1995-1996 and a follow-up in 2004- 2006. Reported experiences of weight/height discrimination included a variety of settings in major lifetime events and interpersonal relationships. The prevalence of weight/height discrimination increased from 7% in 1995-1996 to 12% in 2004-2006, affecting all population groups but the elderly. This growth is unlikely to be explained by changes in obesity rates. Weight/height discrimination is highly prevalent in American society and increasing at disturbing rates. Its prevalence is relatively close to reported rates of race and age discrimination, but virtually no legal or social sanctions against weight discrimination exist.
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            Weight bias among health professionals specializing in obesity.

            To determine the level of anti-fat bias in health professionals specializing in obesity and identify personal characteristics that correlate with both implicit and explicit bias. The Implicit Associations Test (IAT) and a self-report questionnaire assessing explicit attitudes, personal experiences with obesity, and demographic characteristics was administered to clinicians and researchers attending the opening session of an international obesity conference (N = 389). The IAT was used to assess overall implicit weight bias (associating "obese people" and "thin people" with "good" vs. "bad") and three ranges of stereotypes: lazy-motivated, smart-stupid, and valuable-worthless. The questionnaire assessed explicit bias on the same dimensions, along with personal and professional experiences with obesity. Health professionals exhibited a significant pro-thin, anti-fat implicit bias on the IAT. In addition, the subjects significantly endorsed the implicit stereotypes of lazy, stupid, and worthless using the IAT. Level of bias was associated with several personal characteristics. Characteristics significantly predictive of lower levels of implicit anti-fat bias include being male, older, having a positive emotional outlook on life, weighing more, having friends who are obese, and indicating an understanding of the experience of obesity. Even professionals whose careers emphasize research or the clinical management of obesity show very strong weight bias, indicating pervasive and powerful stigma. Understanding the extent of anti-fat bias and the personal characteristics associated with it will aid in developing intervention strategies to ameliorate these damaging attitudes.
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              A multinational examination of weight bias: predictors of anti-fat attitudes across four countries.

              As rates of obesity have increased throughout much of the world, so too have bias and prejudice toward people with higher body weight (that is, weight bias). Despite considerable evidence of weight bias in the United States, little work has examined its extent and antecedents across different nations. The present study conducted a multinational examination of weight bias in four Western countries with comparable prevalence rates of adult overweight and obesity.
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                Author and article information

                Journal
                csp
                Cadernos de Saúde Pública
                Cad. Saúde Pública
                Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz (Rio de Janeiro, RJ, Brazil )
                0102-311X
                1678-4464
                2018
                : 34
                : 8
                : e00088017
                Affiliations
                [1] São Paulo São Paulo orgnameUniversidade de São Paulo orgdiv1Faculdade de Saúde Pública Brazil
                Article
                S0102-311X2018000805008 S0102-311X(18)03400805008
                10.1590/0102-311x00088017
                70fae8d2-2d49-4a84-b798-1868236ebeba

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 23 May 2017
                : 18 December 2017
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 61, Pages: 0
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                SciELO Public Health

                Self URI: Texto completo somente em PDF (PT)
                Self URI: Full text available only in PDF format (EN)

                Nutricionistas,Preconceito,Obesidad,Estudantes,Obesidade,Prejuício,Students,Estudiantes,Nutritionists,Prejudice,Obesity

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