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Health Professionals’ Weight Bias Does Not Help



sharma-obesity-weight-discrimination4Yesterday, I discussed the dire need for health professional education in obesity, a topic of keen interest to Bill Dietz and colleagues in their paper in the 2015 Lancet series on obesity.

This lack of professional training in obesity is not helped by the well known and widespread weight-bias and discrimination that is rampant amongst most health providers, administrators and policy makers (not to mention the general public).

Thus,

“Weight bias by preclinical and medical students includes attitudes that patients with obesity are lazy, non-compliant with treatment, less responsive to counselling, responsible for their condition, have no willpower, and deserve to be targets of derogatory humour, even in the clinical-care environment. These biases can also lead to views that obesity treatment is futile and feelings of discomfort, which students report as a barrier to discussing weight with patients, both of which are likely to impair care.”

These attitudes have real consequences for people living with obesity,

“Providers spend less time in appointments, provide less education about health, and are more reluctant to do some screening tests in patients with obesity. Furthermore, physicians report less respect for their patients with obesity, perceive them as less adherent to medications, express less desire to help their patients, and report that treating obesity is more annoying and a greater waste of their time than is the treatment of their thinner patients”

It should come as no surprise that patients who experience these attitudes are less likely to seek medical care, even when needed,

“Among the heaviest women, 68% reported delaying use of health-care services because of their weight, due to previous experiences of disrespectful treatment from health-care providers, embarrassment about being weighed, and medical equipment that was too small for their body size.”

This not only directly harms patients but also substantially adds to the cost of the disease as the delay in diagnosis and treatment for obesity-related comorbidities can impair the quality of care for individuals with obesity.

However, these challenges are not insurmountable,

“Information about obesity that indicates contributing factors beyond personal control (eg, biological and genetic contributors) as well as the difficulties in obtaining clinically significant and sustainable weight loss, has been shown to reduce negative bias and stereotypes among preclinical and medical students and improve self efficacy for counselling patients with obesity.”

This is why the Canadian Obesity Network has made addressing weight bias and discrimination its #1 priority in all educational activities geared to health professionals and decision makers.

As long as we basing our discussion of obesity prevention and treatment on unhelpful and harmful stereotypes, we will not be helping the people who actually have the problem.

@DrSharma
Edmonton, AB

4 Comments

  1. Even my own family doctor has very little knowledge or sympathy to help me with losing weight.

    In fact i am at a point where i do not even want to ask him for help with my obesity issues.

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  2. The weight bias is very engrained in the health industry. Instead of focusing on the health of the patient, the health industry seems to be more focused on whether you have met the criteria of some weight chart.

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  3. many years ago, I went to my GP with symptoms of tiredness, and even though I wasn’t losing any weight at all, I swore to him that I was dieting and spending over an hour a day on a treadmill. I suggested that, like my mother, maybe I had thyroid problems. He fairly yelled at me that I was just overweight, that he would do the tests, but if they came back negative HE WAS PUTTING ME ON A DIET!!

    My husband met me in the parking lot and when I saw him I collapsed into tears at being humiliated. A few days later, the dr. called me and said I did have a thyroid issue, and he would prescribe medication for it- as if nothing had occurred in his office.

    So, I totally get why heavy people don’t like to go to doctors. They often sound like if they answer the question “why” or “how” a malady has come into being, that is enough, as there is no quick fix script to write out.

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  4. Our whole family of five suffers/d from obesity. The situation here is so bad that one family member can’t even apply for a new GP because h/she already has one. Sadly that doctor doesn’t “believe” in depression as an illness and is unwilling to get treatment for my family member. I believe this is partly because h/she is suffering from morbid obesity. What does one do in a situation like that! Needless to say there is a real reluctance to visit that GP for any reason at all. That is very dangerous.

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