Do doctors have a weight bias?

There’s no question about it: We live in a fat-phobic society. Negative weight-related attitudes include believing that obese people are lazy, lacking in willpower and generally unhealthy. Their excess weight is thought to be their own fault.

How common is weight discrimination? A study published by the Obesity Action Coalition found it increased by 66% over a 10-year period from 1995-2005, making it more prevalent than discrimination based on ethnicity, sexual orientation and physical disability. Among women, weight discrimination was even more common than racial discrimination. And almost 60 percent of the study participants reported at least one experience of employment-based discrimination, such as not being hired for a job.

Obesity is highly stigmatized in all kinds of settings—from the workplace to the schoolyard—and, yes, even in the doctor’s office.

Weight bias remains socially acceptable in our culture. But when it occurs in the healthcare setting it can have dire consequences. For example, sometimes serious health issues are blamed solely on weight and physicians can inadvertently ignore other possible causes. 

We know there is a connection between obesity and certain conditions, such as diabetes and cardiovascular disease, but it’s important to remember that not everyone who is overweight or obese is, in fact, unhealthy. A 2015 study published in the Journal of Clinical Investigation found that as many as 50% of obese adults are “metabolically normal,” with a low risk of these health complications.

Weight is just one of many factors that affect health. Excess weight should not be treated as a flawed personality trait and healthcare professionals need to remember that obesity is a complex condition involving one’s genes, the environment, stress, overall health and personal choices. Bringing up the subject of weight at each and every patient visit can cause shame, which can undermine weight loss efforts and even lead to weight gain. Weight bias can also exacerbate health issues such as disordered eating and avoiding preventive care, 

A 2016 paper published in The Journal of Nurse Practitioners revealed these alarming statistics:

Obesity can affect one’s health status, but it’s not necessarily the most important factor to consider when it comes to good overall health. Regardless of their weight, everyone has the right to benefit from compassionate quality care from their healthcare providers and never feel judged or shamed.