The School of the Teacher

The Power of Educators in Weight Bias

To be an educator might not mean much for a person’s income. But it confers tremendous power over the lives of students and thus our communities. Two publications this week remind us of the great power that educators have – for better or worse – in weight bias.

Affirmation by a Teacher

In a video by Camila Kater in the New York Times, a woman named Rachel tells of her experiences as a fat child. Her mother was very disapproving of her body. But at school she found acceptance.

“I was always fat as a child. But my weight was never an issue in school.

“There was a semester that we had a gym class focused on running. Whoever was skinny and long-legged ran very fast. And there was Cidao, who was really fast. Then we went for the long-distance race. I took one lap around the track, then two laps, then three. On to the fourth lap, I was still feeling great. And my friends were like dying.

“At the end, my teacher said, ‘We can’t be good at everything. Cidao runs very fast, but Rachel can run for a long time.’

“Without this experience in school, I think I would have been broken. Honestly.”

Educators in Healthcare

A new study by Sean Phelan and colleagues suggests that medical educators might have tremendous power over the problem of weight bias in healthcare. Phelan studied how third and fourth-year medical students interact with standardized patients who have obesity. He wanted to see if a student’s implicit or explicit bias might influence they way they care for a patient.

But what he found was surprising. Implicit weight bias did not predict less attentive, respectful care. Nor did explicit negative attitudes toward people with obesity. Rather, what mattered more was the norms of the the medical school. Role modeling of discrimination by educators was especially important. In other words, a medical student’s pre-existing bias did not seem to matter so much. What might make more of a difference is the power of a medical educator to set an example for respectful, attentive, patient-centered care without weight bias.

Fair Game?

Back in 2006, Delese Wear et al studied derogatory and cynical humor in clinical settings. In this qualitative research, they found that patients with severe obesity were the number one target, deemed “fair game” for derision.

We like to think that attitudes have improved since then. But Phelan’s research tells us that this problem has hardly disappeared. If we want to stop weight bias, educators can play a key role. Right now, some are helpful and others are not.

Education at all levels should have zero tolerance for bias and discrimination in all its forms. Educators have great power to stop weight bias.

Click here for the Kater video, here for the study by Phelan et al, and here for the study by Wear et al.

The School of the Teacher, painting by Francisco Oller / WikiArt

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January 15, 2021