Weight Bias among Health Professionals Specializing in Obesity

Abstract

Purpose: To determine the level of anti‐fat bias in health professionals specializing in obesity and identify personal characteristics that correlate with both implicit and explicit bias. Research Methods and Procedures: The Implicit Associations Test (IAT) and a self‐report questionnaire assessing explicit attitudes, personal experiences with obesity, and demographic characteristics was administered to clinicians and researchers attending the opening session of an international obesity conference (N = 389). The IAT was used to assess overall implicit weight bias (associating “obese people” and “thin people” with “good” vs. “bad”) and three ranges of stereotypes: lazy‐motivated, smart‐stupid, and valuable‐worthless. The questionnaire assessed explicit bias on the same dimensions, along with personal and professional experiences with obesity. Results: Health professionals exhibited a significant pro‐thin, anti‐fat implicit bias on the IAT. In addition, the subjects significantly endorsed the implicit stereotypes of lazy, stupid, and worthless using the IAT. Level of bias was associated with several personal characteristics. Characteristics significantly predictive of lower levels of implicit anti‐fat bias include being male, older, having a positive emotional outlook on life, weighing more, having friends who are obese, and indicating an understanding of the experience of obesity. Discussion: Even professionals whose careers emphasize research or the clinical management of obesity show very strong weight bias, indicating pervasive and powerful stigma. Understanding the extent of anti‐fat bias and the personal characteristics associated with it will aid in developing intervention strategies to ameliorate these damaging attitudes.

Internalized weight stigma moderates eating behavior outcomes in women with high BMI participating in a healthy living program

“…Indeed, weight 65 discrimination has been well-documented in educational, workplace, and healthcare settings 66 (e.g., Giel, Thiel, Teufel, Mayer, & Zipfel, 2010;Neumark-Sztainer, Story, & Harris, 1999; Puhl 67 & Latner, 2007;Puhl, Latner, King, & Luedicke, 2014;Puhl, Luedicke, & Heuer, 2011; Puhl & 68 Peterson, 2014;Ruggs, Hebl, & Williams, 2015;Sabin, Marini, & Nosek, 2012). Even 69 healthcare professionals who have chosen a career path specializing in the medical management 70 of obese patients demonstrate anti-fat attitudes, as assessed implicitly in laboratory research 71 (Schwartz, Chambliss, Brownell, Blair, & Billington, 2003). Given these data, it is no surprise 72 that higher weight individuals report avoiding preventive healthcare and suffer from receiving 73 suboptimal medical treatment (Phelan et al, 2015; Wee, McCarthy, Davis, & Phillips, 2000).…”

Evidence-based medicine reports on obesity surgery: a critique

“…Clearly, the omissions in these reports negatively influenced the perception of the value of bariatric surgery, leading some insurance carriers to deny surgery for obesity. 110 In the United Kingdom, a number of Primary-Care Trusts with fixed budgets do not fund obesity surgery despite the conclusion of NICE, based on the Cochrane report, that the surgery was effective. Had the Cochrane report included all of the available studies on the efficacy of obesity surgery for reversing obesity comorbidities in their review, the conclusion would likely have been much stronger, leading to less resistance toward paying for the operations.…”

“…Blue Cross, Blue Shield of Florida has recently decided that no surgery for severe obesity should be covered because it has not been shown to be effective and the complication rates are excessive. 110 The result of these flawed reviews is that patients with severe obesity are being denied needed coverage for their disabling conditions.…”

Musculoskeletal findings in obese subjects before and after weight loss following bariatric surgery

“…1,2 Physician bias towards obese patients may contribute to the assumption that their painful musculoskeletal (MSK) symptoms are weight related. 3 However, the published literature does not support the association between weight and many MSK conditions.…”