Despite this emphasis on understanding patients insofar as t

Despite this emphasis on understanding patients insofar as they are part of larger communities, these new relationships have not been integrated into the theoretical portrayal of medical relationships or the everyday practice of American medicine. Although the ACA nudges toward, but does not bring medicine fully in line with population health care, there are important steps made in this direction (Williams, McClellan, & Rivlin, 2010). We argue that several interrelated post-ACA openings could help scholars and practitioners alike rethink medical relationships in a way that accords with the theoretical shift we have described, moving the focus from individual patients to Z-YVAD-FMK manufacturer wellbeing and activation.
Strategies to capitalize on ACA investments in population health
Conclusion
Introduction Weight misperceptions – defined as discrepancies between objective indicators of weight and individuals’ perceptions of their weight status – appear common among youth. Roughly one-third of adolescents misperceive their weight (Brener, Eaton, Lowry, & McManus, 2004; Edwards, Pettingell, & Borowsky, 2010; Patte, Laxer, Qian, & Leatherdale, 2016). Overall, underestimations are more common than the alternative, although gender variations exist, with girls more inclined to overestimate, and boys tending to underestimate (Fan, Jin, & Khubchandani, 2014; Jackson, Johnson, Crocker, & Wardle, 2015; Patte et al., 2016). While misperceptions of being overweight have long been a focus in the eating disorder field, more recently, researchers have expressed concerns that individuals with obesity who underestimate their weight may lack motivation to engage in health behaviour changes (Deschamps, Salanave, Chan-Chee, Vernay, & Castetbon, 2015; Duncan et al., 2011; Fan et al., 2014; Jackson et al., 2015). Indeed, weight perceptions have been shown to predict weight-control intentions, regardless of objective weight status (Duncan et al., 2011; Edwards et al., 2010; Patte et al., 2016); however, given the difficulties inherent to weight management, and behaviour change in general, intentions may not translate into healthy behaviours. Considering the low proportion of youth that meet guidelines for nutrition and physical activity (PA), and the persistently high obesity rates (Leatherdale & Rynard, 2013), understanding how weight perceptions impact health behaviours is critical and has important implications for health promotion strategies. Given the extensive media and public health attention to obesity, individuals of any size who perceive their weight to be “normal” may fail to appreciate the need to improve their eating and PA habits. These individuals could plausibly disregard messages about nutrition and exercise as not relevant to them, since these campaigns are often framed in the context of weight loss. In fact, people who perceived their weight as healthy were reportedly more likely have poor diets (Skinner, Weinberger, Mulvaney, Schlundt, & Rothman, 2008), and less likely to be physically active (Duncan et al., 2011; Murillo, Ali, Carmack, & Doss, 2016; Skinner et al., 2008) or to see a need to increase their PA (Lechner, Bolman & van Dijke, 2006). In response, approaches to correct weight misperceptions have been advised to improve buy-in for obesity prevention efforts (Deschamps et al., 2015; Duncan et al., 2011; Fan et al., 2014; Jackson et al., 2015). Conflicting views caution that addressing weight misperceptions could prove detrimental among heavier individuals (Burke, Heiland, & Nadler, 2010; Frisco, Houle, & Martin, 2010; Sonneville, Thurston, Milliren, Gooding, & Richmond, 2016). Not only does perceived weight appear to account for many of the adverse psychosocial consequences of obesity (e.g., depression, suicidal ideation; Duncan et al., 2011; Minor, Ali, & Rizzo, 2016; Roberts & Duong, 2013; ter Bogt et al., 2006), but emerging evidence suggests that increasing recognition of overweight/obesity may discourage health behaviours, potentially through internalized obesity stigma and/or body dissatisfaction. For instance, among youth with weights in the overweight or obese range, accurate weight perceivers consumed more fast food and soft drinks (Khambalia, Hardy, & Bauman, 2012), and were less likely to meet recommendations for PA and fruit and vegetable intakes (Edwards et al., 2010; Fredrickson, Kremer, Swinburn, de Silva, & McCabe, 2015), compared to their peers who underestimated their weight. Likewise, in a large sample of Canadian youth with a range of body weights, perceptions of being overweight were positively associated with low PA and high sedentary behaviour (Wong & Leatherdale, 2009).