Weight bias and effective treatment

Some interesting research from Yale and other American Universities suggests that we should be careful to resist the prevalent social attitudes about obesity and weight…

Unfortunately, there is some American research that suggests that some patients don’t receive optimal care in various healthcare settings because of their size. Healthcare practitioners who judge a patient to be overweight or obese can sometimes too quickly assume that this is the root cause of their problem. Also, sometimes, a clinic or practitioner can alienate larger patients through subtle verbal or nonverbal behaviours.

These kinds of behaviours are not confined to healthcare. Cognitive bias of all kinds are prevalent in many industries.

The tricky part is that weight is a factor to consider in many diagnoses. In the same way I may think about if a runner is a heel striker, or a forefront striker; or how I conduct an intake for someone with back pain who sits a lot at work; or whether someone picks up their kid with their left or right side when they have a shoulder injury. On some level, it’s just physics and there’s no stigma.

However, science works best when it acknowledges the foibles and failings of the humans that implement it. And there’s some interesting research that tells us that weight bias is common enough to be a real concern among healthcare professionals. In one study where 329 healthcare professionals were interviewed about the social stigma regarding overweight or obese people, 29% “reported that their colleagues have negative attitudes toward obese patients.”

The professionals with greater weight bias were more likely to attribute obesity to behavioural factors and, unfortunately, expressed stigmatizing attitudes about obese patients, and “perceived poorer treatment outcomes for these patients.”1

The International Journal of Obesity published research from Yale University that showed weight bias was as prevalent as racial bias.2 We know that weight bias and weight stigma are prevalent and we hope that healthcare professionals do the work to resist those attitudes and behaviours.3

In one American study of over 620 primary care physicians, a whopping 50% viewed obese patients as “awkward, unattractive, ugly, and noncompliant.” And a whopping third of these physicians further described these patients as “weak-willed, sloppy, and lazy.”4

That’s very serious. We’re in healthcare and we don’t want the weight of our patients to be a barrier to positive, effective treatment.

But the social stigma around weight has been going on for a long time. And the result is that there could be hosts of people out there with problems they are not motivated to seek help for, because they have, directly or indirectly, been made to feel shame or have felt the impact of negative attitudes because of their weight.

We hope that’s not the case. And we endeavour to create a welcoming space for people with all kinds of bodies.

  1. “Weight Bias among Professionals Treating EatingDisorders: Attitudes about Treatment and PerceivedPatient Outcomes”, 2013, by Rebecca M. Puhl, PhD, Janet D. Latner PhD, Kelly M. King, MPH, Joerg Luedicke MS.
  2. Yale Study Shows Weight Bias Is as Prevalent as Racial Discrimination: International Journal of Obesity (March 4, 2008) doi: 10.1038/ijo.2008.22
  3. http://www.obesitynetwork.ca/files/5AsT_WeightBias_Resources.pdf
  4. Rebecca M. Puhl and Chelsea A. Heuer: Version of Record online: 6 SEP 2012 DOI: 10.1038/oby.2008.636

Posted by Libby Meakin

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