Two Women Teaching a Child to Walk

Teaching Contempt for People with Obesity?

UPDATE: Within days of our posting below, Medscape posted the following retraction notice.

While we welcome thought-provoking and even controversial points of view in our commentaries and in comments from our readers, we do not endorse weight bias, nor bias towards any group. After careful review, the editors at Medscape have decided to retract this commentary. We understand how this commentary could promote stigma and marginalization.

We see it on display with dismaying regularity. Contempt for people living with obesity. Where does it come from? New research in the International Journal of Obesity suggests that it comes from ignorance. But fortunately, ignorance is more readily curable than obesity.

Contempt on Display in Medscape

The latest galling display of contempt for people with obesity appears on Medscape. George Lundberg writes with disgust about seeing “so many really fat people shoveling down large quantities of free breakfast food.”

He had ventured out into rural America. In his travels, he seems to have marinated in his disgust for Americans staying at the mid range hotels he selected for this visit with the common people. They eat “anti-nutritious garbage,” he says. In addition he notes, “I never saw one person exercising.”

Finally, he concludes sarcastically that life is short. Maybe he’ll just pig out on root beer floats and banana splits like all the fat people he’s been seeing.

We have just one question for Medscape. How in the world does this hate-filled screed have anything to do with your mission? What part of this rant will help to improve patient care?

Instruction That Promotes Weight Bias

An elegant new study in the International Journal of Obesity tells us exactly why this kind of ignorant rant can be so harmful. The underlying message is that obesity is simple. Diet and exercise is the cause and the cure.

Nadeeja Wijayatunga and colleagues studied the effects of teaching such a simplistic view to kinesiology students. They found that it served to cause an increase in implicit bias against people with higher body weight.

But providing a more complete picture did not. After learning a bit more about the full range of factors that cause obesity, implicit bias did not increase. In fact, explicit bias went down.

Contempt Doesn’t Help

It’s easy to feel contempt for Lundberg after reading his rant. But it accomplishes nothing. That’s how contempt multiplies and we live in an ever more polarized culture.

However, it is clear that good, objective teaching is important. So Medscape should stop giving people a platform for hateful rants. To overcome obesity, we need better provider education, better patient care, and better insight into obesity. Not contempt for the people affected.

Contempt breeds contempt. But education brings progress.

Click here for the Wijayatunga study.

Two Women Teaching a Child to Walk, sketch by Rembrandt / WikiArt

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February 19, 2019

5 Responses to “Teaching Contempt for People with Obesity?”

  1. February 19, 2019 at 7:21 am, Allen Browne said:



  2. February 19, 2019 at 9:58 am, Michelle Vicari said:

    Reading Dr. Lundberg’s ignorant, stigmatizing, stream of thought did do something for my health… it raised my blood pressure. He (and sadly some of the high-five commenters) is one of the reasons I avoided doctor’s offices like the plague. That sort of bias can’t be hidden even for the 15-minute appointment while caring for a person with obesity… we feel it… and it caused me to avoid care while my conditions worsened. Shame on him.

  3. February 22, 2019 at 3:22 pm, Paul Ernsberger said:

    Medscape publishes screeds like Lundberg’s but also enlightened works on medical weight stigma by Rebecca Puhl. Unfortunately, the comments run overwhelmingly towards screeds. The MD commenters are much more prejudicial than those from RN’s or dieticians.

  4. February 23, 2019 at 11:34 am, Chantal Poisson said:

    For years, any time I went to a doctor, I was told that my only problem was my weight. I lost 85 pounds and have been maintaining the loss for more than a year now.

    Suddendly, doctors are listening to me. All of the problems I complained about are now real and solutions are being pursued. I had hip replacement surgery a month ago and will be having the other one done in a few months. Next, both shoulders will get the same treatment.

    It is really insulting to realize that doctors now take me seriously after the weight loss but that I was not worthy of the same treatment when I was obese. I am exactly the same person.

    • February 23, 2019 at 11:50 am, Ted said:

      I hear you Chantal and I hope that everyone will hear you!