Weight Bias and Obesity Discrimination

Can We Shake Weight-Based Stereotypes?

Overweight individuals are often viewed as lazy, less competent, and sloppier in the workplace, classroom, doctor’s office, and at home. Here, suggestions for what can be done to squash these negative stereotypes
By Hollis Templeton fitbie
 

At the Doctor’s Office

Your doctor, dietitian, or personal trainer is there to help you maintain a healthy body, but that doesn’t mean that each of them will always make you feel great. “Health care providers are not immune to weight bias and may express judgmental or negative attitudes toward obese patients,” says Puhl. In fact, when she and her colleagues examined the health care experiences of more than 2,000 overweight or obese women, they found that the women reported receiving inappropriate comments about their weight from doctors (53%), nurses (46%), dietitians (37%), and mental health professionals (21%).

The concern is that obese patients who experience weight stigma in medical settings will delay or forgo essential screenings, like those for breast, cervical, or colorectal cancers. But stigmatization isn’t just in patients’ heads—doctors admit to it, too. More than 50% of physicians view obese patients as awkward, unattractive, and noncompliant, according to a study of 620 primary care physicians published in the journal Obesity Research. A third of the doctors surveyed characterized heavier patients as weak-willed, sloppy, and lazy. Nurses, medical students, fitness professionals, and dietitians express similar attitudes toward the overweight. In a Journal of the American Dietetic Association study on dietetics students’ perceptions of obesity, a majority of students agreed with stereotypes that overweight people frequently overeat, don’t exercise, are slow and insecure, lack endurance, and have low self-esteem and poor self-control.

The good news is that there’s also evidence that suggests your physicians’ perceptions are misguided. Researchers at the University of Kansas Medical Center found that patients’ self-reported levels of weight loss motivation were significantly higher than the levels of motivation that their doctors perceived. Thirty percent of female and 21% of male patients reported a motivation score of 10 or “completely motivated,” while their doctors estimated that only 2.5% of female and 3.1% of male patients were that motivated.

What Your Health Care Provider Can Do

Health care providers should to be mindful of the language used when discussing the health risks associated with a patient’s weight, asking the patient what word or words they feel comfortable with—“weight” versus “obesity,” for example, says Puhl.

Health care providers should also focus treatment on lifestyle and behavioral changes instead of emphasizing weight loss, gaining a better understanding of the biological factors that work against one’s body weight as well as the difficulties associated with losing weight and maintaining weight loss.

Change Perceptions by…

Putting your concerns in writing. If you feel as though a health care professional is treating you unfairly because of your weight, Puhl suggests jotting down a list of your concerns and contacting your health center’s medical advocate.

In her book Health at Every Size, Linda Bacon, PhD, provides readers with letters that they can take with them to their next doctor’s appointment as a way of opening up a dialogue with a health care provider about weight bias.

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