Weight Bias: When Prejudice Stops Progress

“I am ashamed to work in a healthcare profession that treats people in such a manner,” says Rachel Batterham. Batterham is a brilliant researcher and professor of obesity, diabetes, and endocrinology. But on Wednesday at the fourth World Congress on Interventional Therapies for Type 2 Diabetes, she reached outside of her comfort zone to talk about weight bias. This bias against people living in larger bodies threatens the health of people living with obesity. Worse yet, it’s a threat to healthcare and to medical progress.

An Ill-Defined Disease

Professor Francesco Rubino organized the congress to devote the entire closing day to the subject of weight stigma. He explained that we’ve defined the disease of obesity rather poorly. Epidemiologists rely on BMI. But for clinicians, that’s inadequate. What’s more important is to define it by the physiology of fat storage that goes awry in obesity.

Lee Kaplan dove deep into this physiology and common misunderstandings of it that lead to weight bias. Rebecca Puhl delivered an authoritative review of our knowledge about weight bias and how it harms the health of people living with obesity.

By now, it’s pretty clear that stigma causes harm of its own, but it also leads to further weight gain and the progression of obesity into more severe forms. The bias that healthcare professionals wield against people with obesity is truly shameful, as Batterham explained.

Solutions?

Stuart Flint offered an overview of the ways that our culture and the media reinforce bias and stigma. He encouraged working collaboratively with media to try to reduce its negative influence. But he also noted that obesity clinicians and researchers had best address their own biases up front. Tossing stones from glass houses has a bad ending.

ConscienHealth’s Ted Kyle explained that we need both science and humanity to change the media narratives. It’s one thing to correct knowledge gaps. However, the human connection with people living with obesity is essential for winning hearts.

CEO Joe Nadglowski of the Obesity Action Coalition closed the day with a personal view of efforts to change the political discourse. Obesity might be a tough subject, but it doesn’t have to be a partisan one. Everybody suffers from its effects and everyone can gain from more effective strategies.

You can expect a consensus paper on the subject of bias and stigma will be forthcoming. No doubt it will be a fine document. However, the real test will be how we translate it into action.

Click here for Rubino’s presentation, here for Puhl’s, here for Batterham’s, here for Flint’s, here for Nadglowski’s, and here for Kyle’s.

Childhood Is Without Prejudice, photograph © Marc Monaghan / flickr

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April 11, 2019