Professionals Struggle with Weight Bias Issues

Anguish sculptureThe destructive effects of fat-shaming have been observed in many ways. For instance, Sharon Begley reported for Reuters.com that physicians tend to spend less time with an obese patient, and don’t bother to offer counsel on achieving a healthier lifestyle, “perhaps believing it would fall on deaf ears.”

Medical personnel don’t even need to specifically verbalize their anti-fat bias, because it is all too easy to “telegraph” negative attitudes. Aside from being rude, this dismissiveness can cause tangible harm. Being treated badly can cause people to avoid doctors, and when they are reluctant to seek medical help or even have checkups, serious conditions like diabetes can develop unnoticed.

Weight Bias in the Medical Professions

A definitive picture was drawn by Rebecca Puhl, PhD, director of research at Yale University’s Rudd Center. Almost a decade ago, she led an online study of 2,449 overweight and obese women, which involved “self-report questionnaires measuring frequency of weight stigmatization and coping responses to deal with bias, the most common sources of the bias, symptoms of depression, self-esteem, attitudes about weight and obesity, and binge eating behaviors.”

The participants were asked about their history with various categories and types of people such as sales clerks, restaurant servers, friends, employers, and more. The most frequent stigmatizers were family members and doctors. 69% of the respondents said they had experienced stigmatization from doctors, and 52% said it happened more than once. Only 46% had negative bias interactions with nurses. Mental health professionals were way down the list—only 21% of the women had felt stigmatized by something one of them did or said.

In other studies, weight bias has been documented not just among doctors and nurses, but among psychologists, dieticians, medical students, and fitness professionals as well. It is not uncommon for healthcare providers to regard obese patients as awkward, lazy, sloppy, unsuccessful, unintelligent, weak-willed, devoid of self-control, and even dishonest.

In inquiries conducted among doctors, obese patients have been characterized as less self-disciplined, less compliant, and more annoying than normal-weight patients. As patient Body Mass Index goes up, tolerance for the heavy patients takes a nosedive. Physicians admit that they tend to lose both patience and respect for the people who come to them for help, along with the desire to extend that help. It is not unusual for doctors to feel that seeing obese patients is a waste of their highly-trained and specialized time. What happens when healthcare personnel exhibit a biased attitude toward obese patients? Here are some of the negative results cataloged by Dr. Puhl:

Reactions of Overweight Patients

  • Feel berated & disrespected by provider
  • Upset by comments about their weight from doctors
  • Perceive that they will not be taken seriously
  • Report that their weight is blamed for all problems
  • Reluctant to address weight concerns
  • Parents of obese children feel blamed / dismissed
  • Your responses and feedback are welcome!

    Source: “Insight: America’s hatred of fat hurts obesity fight,” Reuters.com, 05/11/12
    Source: “Clinical Implications of Obesity Stigma,” uconnruddcenter.org, 06/27/13
    Image by Rod Waddington

     

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    Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

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