Portrait of Doctor Gachet

Decades of Weight Bias in Healthcare, Little Change

The first ever systematic review and meta-analysis of weight bias in healthcare professionals is bracing. Blake Lawrence and colleagues have just published it in Obesity. It tells us that weight bias in healthcare has been fully visible for three decades. But the work of reversing it has barely begun.

The authors of this analysis note that healthcare professions generally strive to provide good care. However, it’s not clear this is possible if a provider has feelings of disgust for the large portion of patients living with obesity.

The time has come when something has to change.

Studies of 12,818 Healthcare Providers

This review and meta-analysis included data from 41 studies with 12,818 providers.  After three decades of research, it is clear that this is a problem:

“Weight bias was often expressed by HCPs through contemptuous, patronizing, and disrespectful treatment, as well as attributing all of a patient’s health issues to excess weight, which directly contributes to feelings of weight stigmatization and which is associated with avoidance, delay, or cancellation of health care appointments.”

An Unfinished Task

However, it is also clear that much work remains to be done before health professions can solve this problem. Lawrence et al find that we need more robust methods for measuring this problem in the setting of healthcare. This will be an important step in mounting serious research on ways to drive weight bias out of health professions.

Too many people who should know better make the mistake of presuming that obesity is a choice – a behavior. Fixating on weight and body image gets in the way of putting health first. When the American Heart Association defines the right BMI as an “ideal health behavior,” they are promoting weight bias in health professions.

Obesity is a disease of adipose tissue that interferes with health. Not a problem of bad behavior. It is not easily “preventable” – not in our experience of the last four decades. So it is time to get down to the work of eradicating weight bias from health professions. This is essential for health professionals to provide competent care for people with obesity – 42 percent of the population.

We could start by ensuring that every health professional knows what obesity is and what it isn’t.

Click here for the new paper by Lawrence et al and here for more on reducing weight bias in health professions.

Portrait of Doctor Gachet, painting by Vincent van Gogh / WikiArt

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September 8, 2021