The Ethics of Promoting a Stereotype in a Research Journal

Lifestyle Medicine is a new open access journal from John Wiley & Sons. The journal claims to set a high standard, with rigorous peer review. But we are not so sure about its ethical standards. Because the journal is promoting a stereotype about people with obesity. A low IQ is a risk factor for obesity, says this recent paper. So children with low IQs should receive obesity screenings.

These conclusions reflect weak science and strong bias about the intellect of people with obesity. They are promoting a stereotype about fatness and stupidity. It is deeply offensive, harmful, and unethical.

Beneficence and Respect

The declaration of Helsinki is the cornerstone of research ethics. Three basic principles lie at the heart of this guidance: respect for persons, beneficence, and justice. But this paper does harm to all three of these principles. By promoting a stereotype, it disrespects the people who are the subjects of this research. Thus it fails the test of beneficence because this stereotype offers no possible benefit. And finally it promotes the injustice of bias against persons with obesity.

The Harm of Weight Bias

The literature on weight bias is quite clear. It happens in social settings, education, work, and healthcare. False assumptions based on a person’s weight define it. Marlene Schwartz et al explain this in a 2012 publication:

“The stigma of obesity is so strong that even those most knowledgeable about the condition infer that obese people have blameworthy behavioral characteristics that contribute to their problem (i.e., being lazy). Furthermore, these biases extend to core characteristics of intelligence and personal worth.”

Thus teachers single out larger children with assumptions that they are less intelligent and unlikely to succeed. This also extends to higher education. In an especially notorious case, a professor of psychology declared that doctoral students with obesity were unwelcome in his program. At work, employers commonly deny employment and advancement to persons with obesity.

Screening Children of Low IQ for Obesity?

Perhaps the most dubious aspect of this paper is the recommendation to “be screened for obesity on a regular basis.” The authors present no factual basis for a benefit from this recommendation. To the contrary, singling out children as overweight causes great harm. It creates self-stigma, which leads to worse health outcomes and mental health. Labeling a child as overweight results in poorer academic performance.

Clearly, this unsupported recommendation is likely to cause more harm than benefit.

Careful Thought?

At its very essence, this unfortunate paper documents an association between intelligence and obesity. This is a relationship with many unmeasured confounders. Stigma itself can affect cognitive performance. So too can many other social, economic, and cultural factors. Those factors also correlate with obesity. It is a mess of correlations that offer more heat than light.

Wiley tells us that the journal editors gave careful thought to publishing this article. This does not reassure us. It suggests they have no clue about the harm that weight bias inflicts. If this is so, the future of this journal is quite dim.

Click here for the original article, here and here for more on the harm of the weight stigma. To read our further thoughts on this paper, click here.

The Usual Irish Way of Doing Things, 1871 anti-Irish political cartoon by Thomas Nast / Wikimedia Commons

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October 31, 2020