Office Environment Strategies to Reduce Weight Bias

Rebecca M. Puhl, PhD


September 30, 2010

In This Article

How to Reduce Weight Bias in the Office Setting

A number of steps can be taken to improve the physical office environment and make care more accessible and comfortable for patients affected by obesity. These strategies are outlined below:

1. Assess the environment. Determine whether existing medical equipment is suitable and appropriate for patients with obesity. Walk through your office from the perspective of a patient of large size. Is the office welcoming and comfortable for an obese patient?

2. Obtain feedback from patients. Ask for assistance from a patient advocate or from a patient advocacy organization about the suitability of the office environment for obese patients. Conduct patient satisfaction surveys and ask about level of comfort and accessibility in the office environment.

3. Identify areas for improvement. Several checklists have been developed to assist providers and medical facilities to improve the office environment. For example, the American Medical Association has developed a Checklist of Office-based Obesity Care.[6] Guidelines from this checklist include:

  • Provide sturdy, armless chairs in waiting rooms;

  • Provide sturdy, wide examination tables that are bolted to the floor to prevent tipping;

  • Provide extra-large examination gowns;

  • Use large adult blood pressure cuffs or thigh cuffs on patients with an upper-arm circumference greater than 34 cm;

  • Have extra-long phlebotomy needles, tourniquets, and large vaginal specula on hand;

  • Obtain a scale for weighing patients that has adequate capacity (greater than 350 pounds) for obese patients; and

  • Install a split lavatory seat and provide a specimen collector with a handle. Properly mounted grab bars are needed to enable a person to get up more easily. Install floor-mounted toilets and well-supported toilet bowls.

Review these (and more comprehensive) guidelines with your medical and administrative staff, and look for ways to make the office environment more accessible and comfortable for patients of diverse sizes.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.