Types of Bias in Treating Obesity


One of the big problems with treating obesity is the difficulty of getting some medical professionals on board with certain concepts — like compassion for the pain of obese patients and the challenges they face. An article by Dr. Dyan Hes begins like this:

“How do you do your job?” “I wouldn’t touch those kids with a 10-foot pole!” “Your clinic is a mini-psych ward!” “Nothing works!”

These are just some of the comments I’ve heard throughout my career as a pediatrician who specializes in obesity medicine. What’s worse is that these comments come from other members of the health care community.

Sadly, some doctor-patient relationships are marred by callousness, indifference, disrespect, prejudice, bias, aggression, and bigotry.

How Bias Stands in the Way of Addressing Childhood Obesity” is a presentation created by Ted Kyle, RPh, MBA, with the aim of defining and overcoming bias in the professions that concern obesity and nutrition because, as the Summary states:

Bias causes profound harm: to people, to science, and to health promotion.

The author defines the two types, one of which is weight bias that targets people with obesity, sometimes causing them to avoid the medical profession altogether. When personnel have preconceived notions that obese people are lazy, weak-willed, dishonest, or afflicted with any other undesirable trait, the result will probably not be good. That type of bias takes up only a small portion of the presentation.

The other kind is “intellectual bias favoring personal convictions,” and most of the content comprises issues that the author seems to have strong personal convictions about. Kyle points out that, nationally, to service five million severely obese children, there are only 36 specialized clinics in operation.

He classifies “Promoting breastfeeding prevents obesity” as a myth. On the other hand, he gives this idea the status of a testable hypothesis: “Taxes on SSBs and junk food will prevent obesity.”

None of these points has anything to do with face-to-face office visits, but are more like arguments designed to influence voters. One of the slides says, “Evidence-based care is mostly out of reach for people with obesity.” Perhaps the author has not heard of W8Loss2Go.

Kyle quotes Dr. Robert Doroghazi, who recommends telling patients the truth:

Sir or Madam, it’s not OK to be obese. Obesity is bad. You are overweight because you eat too much. You also need to exercise more. Your obesity cannot be blamed on the fast food or carbonated beverage industry or on anyone or anything else. You weigh too much because you eat too much. Your health and your weight are your responsibility.

Some would say that is only one version of the truth.

Your responses and feedback are welcome!

Source: “What I Wish Everyone Knew About Childhood Obesity: A Pediatrician Explains,” MindBodyGreen.com, 03/24/14
Source: “How Bias Stands in the Way of Addressing Childhood Obesity,” ConscienHealth.org, 2017
Photo credit: Jared Rodriguez/Truthout.org via Visualhunt/CC BY

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About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

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

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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