Can Sub-Optimal Attitudes Change?


Childhood Obesity News discussed two types of bias in treating obesity, and touched on the troubling news that medical professionals are human like the rest of us, and are sometimes prone to unhealthy mental and emotional habits. The urge to prove others wrong is hard to eliminate.

In Sioux City, Iowa, journalist Dolly A. Butz told the story of a Morningside College academic’s conversation with a nursing student who had been caring for an obese child. Associate Professor Shar Georgesen was shocked by the tone of the other woman’s stereotypical and judgmental gossip about the child and the parents.

This is an illustration of why “anecdotal evidence” may deserve more credit from the establishment than it gets. In this case, the real-life incident led to Prof. Georgesen’s decision to find out just how much student nurses know about childhood obesity, and what attitudes they display to child patients and their parents. She was also interested to learn “how they perceive their own ability to work effectively with families of overweight children.”

As part of her doctoral dissertation, Prof. Georgesen created a survey that ultimately was responded to by 102 nursing students from 26 schools in three states. Once it was written up it became research, but, essentially, the study was the product of more than a hundred cumulative personal and subjective anecdotal experiences, inspired by one personal, subjective experience.

The survey participants were asked to read brief fictional stories about two children of different ages, activity levels, weights, and parental weights. Butz writes:

Survey participants were randomly assigned vignettes that varied, some included a normal weight child with an overweight parent, and others an overweight child with a normal weight parent. The nursing students were never told that the survey was specifically about childhood obesity.

The reporter quoted Prof. Georgesen:

When survey participants read vignettes about overweight adolescents who had an overweight parent, they viewed them negatively.

Obesity bias begins fairly early in childhood. There’s evidence that children as young as four or five respond differently to obese peers than normal-weight peers. By the time students come to nursing school, those ideas are pretty well developed.

This matters because when nurses have some kind of issue with overweight kids, the care the children receive is very likely to be affected, and not in a good way. Leaving the topic of attitude assessment, the journalist elicited some very frank comments about the conditions in this field of education:

About 10 percent of nursing students surveyed said their classes haven’t prepared them to talk about weight as a health problem at all, while about 25 percent said they’ve been taught about the health risks associated with obesity, but not how to talk about obesity.

Georgesen said nursing students spend more time in the classroom learning about smoking and alcohol addiction than weight management, even though they’re more likely to encounter a patient who is obese. She said the topic likely doesn’t get the attention that it should because 40 percent of nurse educators are overweight.

The study author does not necessarily claim that all parts of the country are training nurses with a bad attitude. There is, however, a regional cultural trope that demands personal responsibility for one’s own problems. In that paradigm someone, whether child or parents or both, has to accept blame. Asking for help for personal problems does not come easy to Midwesterners, and extending help non-judgmentally may be equally difficult.

Your responses and feedback are welcome!

Source: “Morningside College professor’s research identifies bias among nursing students,”, 04/07/17
Photo credit: John Flannery (DrPhotoMoto) via Visualhunt/CC BY-SA

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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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