More than two-thirds of Americans are obese or overweight. Obesity rates have risen to an epidemic level, contributing to health inequalities and leading to reduced health-related quality of life. When obese and overweight persons face weight bias by health care providers, fragmented care may occur. Ensuring positive relationships with healthcare providers is important in helping those who are obese or overweight. The purpose of this project was to understand the factors that contribute to negative weight bias in the provider-patient relationship and to identify the most effective interventions that would reduce stigmatizing attitudes and support self-awareness, acceptance, and resolution for both patient and provider. The theoretical foundations of cultural humility and self-appraisal in interpersonal relations were applied to inform this project. The Cochrane Handbook for Systematic Reviews framed this systematic literature review. Additionally, Melnyk's levels of evidence was used to evaluate each article. Articles for inclusion were limited to those published no earlier than 2013, full text available, English language, and peer-reviewed. The search identified 102 articles, of which 26 were selected for the final review. Five articles met the criteria for Level VII (opinions of experts), 18 were Level VI (qualitative studies), 1 was a Level V (qualitative review), and 2 were Level 1 (systematic review). The analysis of evidence clarified the issues related to weight bias and supported recommendations for nursing practice improvement in upholding the dignity of all persons with regard to weight. Nurses can pioneer positive social change by becoming role models who advocate for equality in healthcare delivery for persons who are obese or overweight.

Obesity is a public health issue linked to high morbidity and mortality among critically ill patients. There are approximately 15.5 million morbidly obese adults in the United States. The purpose of the project was to develop and implement an educational program using evidence-based protocols for bariatric care to educate nurses and caregivers regarding best practices when attending to obese patients. The practice-focused question examined whether learning about evidence-based bariatric care would improve the knowledge of nurses and caregivers caring for morbidly obese patients in an acute care setting. The theoretical foundation was Bandura'€™s self-efficacy theory. A questionnaire using a Likert scale was used to collect data from the 100 participants before and after the learning intervention. The selection criteria involved the inclusion of all nurses and caregivers working at the adult in-patient unit. A paired-samples t-test was used to evaluate levels of improvement in knowledge of the causes, treatment, management, and care of patients with obesity and the challenges in caring for morbidly obese patients. The findings indicated a statistically significant increase in participants'€™ knowledge of the causes (p < 0.000), treatment, management, and care of patients with obesity (p < 0.000) and the challenges involved in caring for morbidly obese patients after the learning intervention (p < 0.004). Thus, the implementation of an educational intervention may be effective in improving nurses'€™ knowledge of bariatric care. The implications of the project for social change involve the improvement in nurse'€™s knowledge of clinical guidelines, which can lead to increase in patient satisfaction, and improved overall health outcomes.