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Are Obesity Disparities Invisible in Medical Education?

Obesity is growing more prevalent for all. But at the same time, racial and ethnic disparities are growing wider. In the U.S., 42 percent of adults have obesity. For Black women, that number is 57 percent. Despite this high prevalence and wide disparity, though, medical education board exams skip right over obesity and disparities.

The implicit message is clear. Obesity and health disparities related to it have little importance for the practice of medicine. For the purpose of becoming a doctor, it doesn’t matter.

Blueprints for Medical Exams

Siddharth Yarlagadda and colleagues analyzed the all available blueprints for medical exam content. Boards that make up the American Board of Medical Specialties have 24 of these blueprints. They detail the content that board exams will test. It’s very straightforward. To become a doctor, you must pass the medical board exams. So this is what medical students focus upon.

But you don’t need to know much about obesity. Even less do you need to know about racial and ethnic disparities. The authors explain:

“Three-quarters of American Board of Medical Specialties general certificate exam blueprints do not mention obesity. None mention the disparities in obesity prevalence and treatment that contribute to a disproportionate burden of chronic comorbidities and increased risk for worse outcomes in acute health threats like COVID-19.”

Even if We Look Away, It Still Exists

Both obesity and health disparities are uncomfortable problems. Bias in healthcare – both racial and weight-based – is pervasive. Power and privilege protects itself, so the problems persist. Explicit racism is no longer OK. Nor is fat shaming. But that doesn’t stop obvious implicit bias in healthcare. People with obesity avoid doctors because of the humiliating treatment they often receive. People of color are dying from COVID-19 at rates two to three times higher than White people.

Simply ignoring obesity and disparities in medical education does not make them disappear. In fact, it makes them worse. This gap in medical education must be closed with a sense of urgency.

Click here for the study by Yarlagadda et al. For more on health disparities, click here. For more about disparities in obesity care, click here.

We Cater to White Trade Only, photograph by Ben Shahn / Wikimedia Commons

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April 17, 2021

2 Responses to “Are Obesity Disparities Invisible in Medical Education?”

  1. April 19, 2021 at 8:13 pm, Michael Jones said:

    With 42% obesity and >70% overweight or with obesity, and obesity being no respecter of race, etc., I’d say the entire country is being underserved in this regard.

    • April 20, 2021 at 4:31 am, Ted said:

      True enough. There are great disparities in care for anyone with obesity. However, dealing with two layers of disparities at once – racial and weight-based – is quite overwhelming.