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MyHealthNewsDaily
Doctors have similar levels of bias against people who are overweight as the general public, a new study says.
Additionally, physicians are likely not aware of their own biases, the study showed.
"The most striking thing is that physicians are like others in society, and hold negative attitudes about weight," said study researcher Janice Sabin, an assistant professor at the University of Washington. "Our study did not look at behavior, so we don't know whether or not this actually affects the patient-provider relationship," she added.
Previous research identified weight biases in doctors, but the new study found that their level of bias is similar to that of the public.
Sabin and her colleagues included nearly 360,000 participants in their study, including 2,284 medical doctors. The researchers used a computer test designed to measure both explicit biases, of which people are aware, and implicit biases, which people do not recognize they hold.
Results showed that female doctors were less biased against obese people than male doctors. "Even though there was a slight difference, bias was strong among both men and women," Sabin told MyHealthNewsDaily.
Obese doctors were generally more sympathetic to overweight people, the study also found.
Weight bias could affect the nearly two-thirds of people in the U.S. who are overweight or obese, according to researchers.
Rebecca Puhl, director of research at the Rudd Center for Food Policy & Obesity at Yale University, said the study underscores the need to educate doctors about weight bias, and provide them with strategies to reduce bias in their interactions with patients.
"Weight bias jeopardizes patients' emotional and physical health, and that some patients may even avoid future health care because of weight bias in the health care setting," said Puhl, who was not involved in the study.
Weight bias can show up in many ways — doctors may use derogatory language, blame health problems on weight and even deny certain medical procedures based on weight, Puhl said.
But patients have several options if they feel stigmatized by health care providers. They can express their concerns to doctors, and should be specific and assertive in what they would like to see change, Puhl said.
Bringing along a friend or family member to an appointment can also help. "If patients are reluctant to speak to their provider, or feel that attempts to do so have been unsuccessful, patients can alternatively voice their concerns to the Patient Advocate at their health center," Puhl said.
Sabin noted that the study did not demonstrate that overweight or obese patients are actually treated differently by their doctors.
"Just because a person has bias does not mean that they are going to discriminate, and that's something important that I always try to emphasize," Sabin said.
The study was funded by Project Implicit, a nonprofit organization that examines unspoken biases, and is published online today (Nov. 7) in the journal PLoS ONE.
More from MyHealthNewsDaily:
11 Surprising Things That Can Make Us Gain Weight
The Best and Worst Words to Use When Discussing Kids' Weights
Leave a Comment:
"Weight bias can show up in many ways — doctors may use derogatory language, blame health problems on weight and even deny certain medical procedures based on weight,"
Yeah... quite a few health problems are associated with obesity and being overweight. And some procedures and medications are dangerous or ineffective if someone is too fat.
As for derogatory language, how are you supposed to tell someone they are fat without insulting them? I'm sure doctors are polite enough not to call their patients whales or tubbies to their faces. But, there isn't a politically correct way to put "You need to lose some of that extra jello."
There might be a bias, but the bias is generally right.
Many not just a few medical problems are related to overweight such as high blood pressure, diabetes, high cholesterol, shortness of breath due to hypo-ventilation syndrome leading to lung and heart problems, and many more that you can look up yourself. Only a few of over weight people that have not developed those conditions yet. I am not sure what kind of biases these patients faced since the article did not list them out. As for a certain procedure, if the patient is too heavy for a certain procedural "table" or equipment, the equipment may be damaged when this patient placed on it due to weight. How can the doctors perform that procedure? May be the doctors were too polite to tell the patients that. At least now we have open MRI which is not as good as the traditional ones to accommodate the over weight patients and those with claustrophobia. Back then, if you could not pass the hoopla hoop, good luck.
There are quite a few ways to discuss weight with a patient without deragatory terms, yet telling it like it is. Your statement, Sayleigh, could be changed to something more therapeutic by saying, "You need to lose some of your excess weight. What can we think of to help achieve that? What about a realistic goal..." That's just for starters. It can open up things such as what the person is eating, if they are having other issues that could result in compulsive eating and calling for counseling...
One of the largest obstacles I find to weight loss is that my insurance will not pay a DIME toward any sort of care, medical or mental, that has a goal of weight loss. It is pretty hard to sneak in a conversation with a doctor when he isn't supposed to be giving me any sort of help or treatment at all according to my insurance. Hmmm....could that be that there is a fair sized care gap. Yet, I see plenty of comments of folks who would like nothing better than for "fat people" to not get any care at all for ANY condition, based on their weight regardless of what the ailment is. That's not helpful.
I don't think it's a bias as much as frustration with their patients. After counseling patients to diet and exercise multiple times and seeing this advice ignored, who wouldn't be aggravated? People need to step up and begin taking responsibility for their health.
Counseling, yes. Idea brainstorming and PARTNERSHIP in ways for the individual to lose weight based on what the patient enjoys doing (rather than a canned response such as yours of exercise they either aren't physically able or motivated to do), absolutely. Think of all the tools out there for smoking. When doctors counseled smokers (including some of my family members) they didn't break out stereotypes and degrading terms to "smack" them as soon as they walked in, they offered different techniques and ideas to try. How many smokers would tolerate being berated the moment they walked in a medical office? The HORRIBLE language used to demean, embarrass, and make fun of obese individuals on these boards should NOT be tolerated in a medical enviornment. Period.
I lost a lot of weight once. My technique that worked? An eliptical machine in front of the TV that I used two or three times per day, plus a DVD that I liked that ran 45 minutes and did it twice. I also walked. Right now, I live in a house that is far too small to have a machine in front of the TV, I injured my ankle walking a year ago severely enough that it required reconstruction (prior damage from falling out of a golf cart in old-fashioned golf spikes), and I am now petrified, literally, of walking for exercise outside. I am working to devise a way for me to do exercise I enjoy that won't cost anything but will alleviate my very real and potentially damaging fear of walking outside on uneven pavement. It takes the slightest dip for my ankle to roll out completely and there isn't much salvagable left if I do any more damage. It is frustrating, but I am NOT giving up!!!
It's one of the biggest known prejudices across the board, irregardless of race, color, gender, age, ethnicity, etc.
And no one needs to inform someone who may be over weight at any time. Not everyone is meant to be a barbie doll. What a boring world it would be if everyone were the same.
Personal happiness is more important than anything else, and that doesn't come in a size. Just my opinion.
And not everyone should be the Michelin Man. If doctors counsel smokers to quit because of health reasons, they should also counsel weight loss.
And personal happiness does not trump all.
If you used irregardless in your sentence, your point is now moot.
What a waste of money and time. Project Implicit must be having a hard time coming up with studies to fund. Considering the adverse health effects of obesity, doctors should have some bias against it just as they should have some bias against smoking and other unhealthy behaviors. If these people really wanted to have an impact on obesity, they would study its major causes not the bias against it. For example the food industry's use of tactics to sell more products such as the use of Madison Avenue psychology in advertising, addicting techniques in flavoring and food "enhancement", etc.. The grocery stores shouldn't be making it easier for these people to get to the food by providing them with motorized carts. If they are too fat to make it to the food on their own, then they don't need the food. Alternatively, there should be evenly spaced bars on the entrances that prevent people over a certain level of obesity from entering until they lose some weight.
agree with most except the bars .
yes they are biased against plus sized patients ! i had a doctor tell me " when you step on my scale please dont break it " thats why she is no longer my doctor
ever take that as a sign?
Lets talk about what nurses have to say. Honestly, we hurt our backs taking care of MOST of the patients on the cardiac units because they are fat as cows. The diabetes, the hard disease, they did it to themselves. Can you not see your feet anymore? Well, its time to lose the lard.
Yes! Absolutely!! I had a doctor blame a car accident on my being overweight. I also had a doctor tell me one time that there was nothing wrong with me except I was too damn fat. And then there was the one who said I was either a liar or a drinker, of which I am neither. I've also experienced nurses with bias to overweight people--many times. I find women doctors more sympathetic towards me than men. It's easier to avoid going to the doctor than being told repeatedly the same things.
I also find it depressing when a person who is overweight has an unfortunate incident befall them. Cancer: if you are overweight it is your fault because "obesity causes cancer". If you are thin, there's so much sympathy...nothing about any habits the person may or may not have had. Accidents, "you are just too big to ____" fill in the blank with any activity- walking, biking, running, ice skating, sledding... yep, I've heard that. If you are thin; you "take care of yourself" and if you get hurt people gush things such as, "oh, so sorry about that. Is there anything I can help you with?"
I've also been as much as called a liar. Especially when I describe what I did to lose weight. Above I described exercising in front of the TV. I purposely left out of that a rather radical diet change, that was counted based on published calorie counts on the products I purchased. I have absolutely been called a liar by Newsvine posters and doctors alike, claiming there is "no way" I could have eaten the calories I did, that people always under-estimate the calorie counts. If I had, I would not have lost the weight! I went from 205 lb to 136 lb. I'm only 5'3, so it was quite a change. After 8 months, I went from classified as morbidly obese to being simply obese. I ate (counted meticulously) no more than 4-500 calories per day, and averaged somewhere in the neighborhood of 6-8 hours of truly sweat-inducing, can't-talk strenuous physical strength-building exercise. EVERY day. I was always muscle sore, my mood swings were frightening, the exercise became something I felt anxious to the point of nauseous if I missed, and I HATED eating. I shook, my hair became brittle, and I was just simply miserable. When I found out I was expecting my second child, reality became that I had to give that lifestyle up. I continued to exercise, but eating only what was recommended for pregnancy resulted in a healthy daughter and the habits and cycle of eating little went away.
I'm trying to go back to the exercise now, but it's 12 years later and my body is in worse shape than it was before my last weight loss; a few injuries and nerve problems have taken care of any addiction I had to weight loss. It does give me pause, though. Especially when I try to follow a "plan" including Weight Watchers, I manage to gain weight. Ugh!
If you have a physical problem CB, though, that you know is real, do not buy into it being you just being fat. Try to get a second opinion and be upfront with the doctor. Advocate for yourself. And take care of yourself the best you can. I wish you luck; some day maybe there will be better ways of looking at things and help for obesity that will be more effective than canned responses to desires to lose weight!
Miskaffon, you might have a thyroid issue, have a doctor check both thyroid glands out. Sometimes one can be working well while the other one isn't. My mom went through something similar to you, but hers wasn't nearly as bad. Thankfully, thyroid issues can mostly be managed by medication.
Yes, Seyleigh, true; I have been on thyroid replacement therapy since I was 19 years old....Seems to be "normal" now. My weight, not so much. I barely think of it and your note reminded me.
I am falling in to that category. I look at grossly overweight people now and think...less health care dollars to fight cancer and other illnesses.
Remember also that the government is now pushing to re-imburse health care providers on the basis of the "quality" of care, rather then "quantity". This means you will get paid less if your patient outcomes are poorer. Since obese patients tend to have higher complications and poorer outcomes there will be incentives to avoid treating these, and any other, high risk patients.
My fat spouse used to have a fine doctor in a teaching practice who eventually diagnosed him with severe sleep apnea, but he first spent months running a gauntlet of incompetent trainees who told him confidently that he was waking up gasping for breath and passing out because of things like GERD (don't all fatsos have GERD?). At the time, he had not been severely victimized by the system, so I did not normally go to his doctor appointments. But I started to suspect that he was not getting adequate care, so I went with him once. The young female intern or resident who saw him spoke almost exclusively to me, talked about him in the third person, and made eye contact only with me. (I'm thin.) Of course, this was hurtful to him. When she left the room, I'd make fun of it by saying (mimicking her accent) "I can't bear to look at the fat man!" Fine, he's no Chippendale dancer. If you can't force yourself to respect his dignity as a human being, go into a No Patient Care specialty. Can we expect such a squeamish little flower to give her patients wise real-world advice on lifestyle change? Or to give it in a way that's positively motivating? Fat chance.
nobody ever likes hearing they're overweight, but sometimes it has to be done. It should be done politely and respectfully
Yes! A bit of creative thinking and problem solving go a long way as well.
The fat-a**es will be charged a surcharge on their insurance premium under Obamacare. SO all the fat blimps that voted for him deserve to get billed.
That's about the only good thing that I've ever heard about Obamacare. It only makes sense that the more fat (oh, I'm sorry obese) people there are the more insurance companies are at risk covering these peoples and our premiums go up. I haven't had to have one doctors visit in 10 years and yet premiums go up every year. Not fair for me I am healthy.
Even better, how about an insurance plan that won't accept you if you are overweight!!!! Why should I have to pay inflated prices because of your inflated waistline????
I doubt the doctors are biased soley because the people are fat.
I would conjure the guess that the doctors have become tired of dealing with fat people who disregard their advice to lose weight despite it being in their best interest. How many hundreds, if not more, conditions are caused or worsened by being over weight?
Willing to say the doctor doesn't hate you because your fat, but because you won't do anything about it and keep getting sicker.
Yeah no kidding! I used to work at a gym and overweight people are full of nothing but self pity and excuses. Self pity over their health problems and every excuse in the world to do nothing about it! Its pathetic. Lots of respect for the people who do fight the fight and succeed, your kind is too few in this world today.
I understand that diagnosing and working with people with a larger amount of adipose tissue is very different from that of a person with smaller amounts. Fine. Then train these physicians on HOW to deal with large clients! It appears to me that fat bias is something that is being passed on during physicians training and that it is something that CAN be changed. If you, as a physician, don’t know how to handle it, find out.
A 2010 study, Reducing Anti-Fat Prejudice in Preservice Health Students: A Randomized Trial, stated that: “Anti-fat sentiment is increasing, is prevalent in health professionals, and has health and social consequences. There is no evidence for effective obesity prejudice reduction techniques in health professionals. The present experiment sought to reduce implicit and explicit anti-fat prejudice in preservice health students.” And that, “The present results show that anti-fat prejudice can be reduced or exacerbated depending on the causal information provided about obesity.”
The American Medical Association has said that denying a patient treatment or to even refusing to enter into a relationship with someone that is overweight or obese is ethical behavior. If this is ethical treatment, the word needs redefining… it’s discriminatory. In case I have forgotten, aren’t we the ones hiring them??? Shouldn’t WE be the ones interviewing and screening THEM to see if it’s a good fit?
If you are a large person and wish to discuss “ethical” treatment with your doctor, please share NAAFA’s “Guidelines for healthcare providers who treat fat patients” with your physician. The brochure is available to you online at
I have experienced this myself with one of my doctors. Before I had Gastric Bypass Surgery, he was extrememly rude and condecending towards me because of my weight. And how do I know it was weight related, you ask? Because he said so himself! He had no "bedside manner" what so ever and treated me really awful. I went to a new doctor after that-one who was extremely kind and understanding.
Fast forward ten years---I've had the Gastric Bypass and I've lost over 250 lbs. I now weigh just 115 lbs. and I have to return to the "rude" doctor because there is no one else in this area that provides treatment for this. I was not happy that I had to go back to him, considering my last experience with him. But low and behold, he's now mister "nice and wonderful" because I've lost the weight. I didn't bring up the weight loss, I wanted to see if he remembered me from the last time--HE brought it up! I really don't like the fact that now I get treated like a "human being" with feelings, just because I'm thin. If I had the choice of not going back to this doctor, I wouldn't. Not only because he treated badly, but because I can just imagine how many others have had to endure his "shaming" because they're overweight.
If you've never been overweight, you have NO idea what it's like and you have no idea how your so called "helpful" suggestions are anything but! Losing weight is the hardest thing anyone has to do. It's not like a drug addict-they don't need the drug to survive. You need to EAT to survive! I had been overweight my entire life. I was put on a diet when I was 5 yrs. old for crying out loud! I finally found my way of dealing with my weight issues. And trust me, having Gastric Bypass Surgery is by no means a walk in the park either. To get to where I am today, I have to give up alot. And I know you skinny people are all going, "Well, that's what you have to do!" Well, having to give up vegetables, fruits, red meat, milk, etc. um yeah, that's a fair trade off...not! I can NEVER eat an entire meal again. I have to think about EVERY bite of food I eat because I only can eat a few bites of food before I'll get sick. I now have have High Blood Pressure, which I NEVER had when I was fat (I had LOW HBP all my life before the surgery!), I'm also Hypoglycemic and I'll pass out if I eat too much sugar or I if I don't eat.
So, all you skinny people who think you know so much about what it's like to be fat and what it takes to lose weight, you don't have a CLUE!! For people like me, it took a HUGE commitment, and for me, one I can never get out of. Am I sorry I had the surgery? Sometimes, yeah I am because it really restricts your life. But, after 13 years of keeping off 250 lbs and not gaining it back, I guess I'm doing something right and it was, in the end a good decision.
Yes, Doctors are humans too and have the same issues as everyone else does. They ALSO are supposed to be caring and respectful of the people they treat. Is being overweight any worse than being really ugly to look at? And do they treat those patients rudely? I'm guessing they don't. So they need to get off their high horse and put themselves in that person's shoes. How would you like it if someone treated YOU rudely and made you feel belittled just because you were overweight? Once you do that, then maybe your overweight patients would respond to a useful dialogue about weight, how hard it is to lose it and see that just because someone is fat, that does not mean they deserve any less compassionate treatment than anybody else.
Ok, I'm just going to say what the people in this article tip-toe around saying cause they are pnssies. IF YOU ARE FAT, YOU ARE A BURDEN ON SOCIETY! Please reply if you need an explanation.
And you Ispeake, I won't tip-toe around. You appear more likely to stick out your foot and trip a fat person to prove they are a burden than to actually do anything to solve the problem. Jonathan Swift would have been proud of you as a specimen yahoo. You would rather blame the person than realize that much of the obesity epidemic is the result of not so great reseacrh causing a plague of unrecognized manmade deficiency diseases.
No, the "fat" people of the world are not the burden on society...YOU ARE!! Ignorant, stupid, small-minded twits like you do nothing to help find a fix for the problem. Idiots like YOU just make it harder for other people to do so.
Let's get down to the meat and fat of the matter. As it turns out, NOW that I am post-fat, that the fat and multitude of other problems I had were the result of a hidden vitamin deficiency (mostly paradoxical folate deficiency). With that and the secondary deficiencies corrected so did my weight and most other symptoms. So while the docs were telling me for 50 years to "lose" weight and everything will get better. they blinded themselves to the real problem and that almost killed me with congestive heart failure. As I worked in the group health arena as a data analyat and software designer I had to deal with identifying reasons for dis-satisfaction wih docs and treatments. You better believe their prejudice exists and is very costly in terms of fat people getting good medical care. Some people do overeat terribly. Most do not. The average fat person is often only overeating by a teaspoon of sugar a day worth of calories. When in paradoxical folate deficiency mode I gain 2-3 pounds a day whether I eat or not. When corrected it can come off at 1-3 pounds a day. NONE of that is caloric in nature.
For some percentage of fat people out there I will tell you what makes the difference for me. For most of my adult life I have eaten less than 1500 calories a day. I'm 6 feet tall now and an inch taller some years back. While the proper usage of these items is pretty complicated becasue they are very powerfull and people who willl benefit have to be ready for some heavy duty startup mostly in the form of induced deficiencies. Look for "Active b12 protocol". It's based on the Deadlock Quartet of nutrients; AdoCbl (adensosylb12), MeCbl (methylb12), L-methylfolate (Metafolin is major brand) and L-carnitine fumarate. The lack of any of these 4 can deadlock ones metababolism and entire biochemstry and healing. Taking off weight with these is very easy for many and impossible without them. Other vitamins and minerals are needed. Find details before you do because some side effects of rapid healing if not handled can be dangerous and even deadly.