Obesity rates are at epidemic proportions, and we need more research to create evidence-based, holistic, and sustainable strategies for prevention. That’s why when Stephanie Jalaba, assistant professor and principal faculty in the MSUCOM Physician Assistant (PA) Medicine program, was invited to publish in the recent Physician Assistant Clinics prevention issue, she chose obesity prevention as her topic.
During the process, she collaborated with her PA program colleagues Heather Trudeau, an assistant professor and pre-clinical coordinator, and Scott Carlson, medical director and associate professor, who she knew also had a strong background in primary care and an interest in obesity topics such as weight bias and stressors.
Jalaba herself has a background in exercise science, and believes PAs have great potential to make an impact in obesity prevention. “Obesity is an under-addressed epidemic that poses a significant threat to our population. PAs have a unique opportunity to address obesity prevention as primary care trained clinicians, and many PAs are currently working in primary care,” Jalaba explained. Primary care is where the bulk of obesity prevention takes place.
But when putting together the review, Jalaba and her colleagues wanted to be sure they discussed a fuller picture of what prevention can look like. “Obesity is a very complex and multifactorial disease. Because of that there isn't a simple one-size-fits-all solution,” Jalaba said. Because obesity has been prevalent for so long and progress has been lacking both on a national and global level, it’s time to start thinking outside the box. That means going above and beyond the typical diet and exercise approach, she added.
That’s why the goal of this publication was not only to emphasize the importance of obesity prevention efforts, but also to highlight and provide some guidance on less commonly recognized factors that may play a role in obesity, such as weight bias and discrimination, stress, and adverse childhood events.
In particular, weight bias, stigma, and discrimination areas where primary care professionals can really make a difference. “These phenomena sometimes stem from generalizations that individuals with obesity are often personally responsible for their condition. This negative bias produces assumptions, beliefs, and judgments that affect the way individuals who are overweight or obese are treated in society,” Jalaba noted.
There’s a plethora of research showing that weight bias happens at an alarming rate in healthcare settings, which can not only result in substandard care, but also have negative effects on an individual’s health. Plus, patients may choose not to seek healthcare in the future due to negative experiences with biased practitioners, which can in turn leave important health issues unaddressed.
The takeaway: “For healthcare providers, it is prudent to be more conscious of examining weight biases and how they may affect patient outcomes,” Jalaba said. “ Patient-provider trust and relationships are so important, especially when it comes to sensitive topics such as obesity.”
Another area the publication digs into is stress and its impact on weight. “Stress has many harmful effects on the body and is often less thought of when addressing obesity prevention,” Jalaba explained. “Even at a young age, stressors lead to unhealthy behaviors and can cause unfavorable metabolic and neurobiological effects.” By approaching obesity prevention from a more holistic point of view, the hope is that it will be possible to make a bigger impact.
In addition to the publication’s clinical significance, it’s also a great representation of how scholarly work and other developmental activities are a priority for those involved with the MSU PA Medicine program. “Professional development has become a large focus within the PA profession and especially within academia. Not only does it support our advancement in healthcare and educational systems, but it’s also a way to continue advancing our knowledge in healthcare in order to better treat our patients, to educate and mentor others, and to give back to the profession.”