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Does Confidence = Competence in Obesity Care?

A new study in Obesity tells us that allied health professionals with a lower BMI believe they are more successful in helping people with obesity lose weight. This research from Sara Bleich and colleagues at the Johns Hopkins Bloomberg School of Public Health complements an earlier study. In that one, they showed that physicians with a lower BMI report more confidence and success in helping people with obesity lose weight.

Caution would be wise as you interpret these results for a couple of reasons. In the first place, all of this data is based upon self-reports. Thanks to the work of Justin Kruger and David Dunning, we know that cognitive bias leads incompetent people to overestimate their skills and overlook their own poor performance. Paradoxically, more skill leads to a lower appraisal of one’s own performance.

Second is the false assumption that a professional with a lower BMI can provide a better role model for healthy diet and exercise. Some people with a normal BMI have atrocious diet and exercise habits. Some people with a high BMI have worked very hard to cultivate healthy diet and exercise habits. Likewise, skilled professionals come in all shapes and sizes.

Despite the need for caution, Bleich has identified a phenomenon worth recognizing. She notes that most health professionals (71%) do not feel successful in helping people with anything less than class III obesity. The challenge is to develop both confidence and competence in a broad range of healthcare professionals, regardless of their own BMI.

Click here to read more in Science Daily, here to read the study of allied health professionals, here to read the study of physicians, and here to read the research of Kruger and Dunning. For a snarky, but entertaining account of the Dunning-Kruger effect, click here.

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