The Enigma

Weight Bias Not a Problem Here? Think Again

Every now and then we have to suppress an eye roll when someone tells us that weight bias is not a relevant concern where they are. If only. We have to suppress an eyeroll and find a gentle way to encourage them to think again about the impact of weight bias in their setting.

Two fine examples showed up in the literature recently. In the International Journal of Obesity, Giovanna Muscogiuri tells us that “weight bias speaks Italian, too.” And then there is the new study by Sally Abbott documenting the pervasiveness of implicit weight bias among healthcare professionals (HCPs) working in bariatric surgery services.

Almost a Universal Experience

The research by Muscogiuri et al was an online survey conducted among members of Italian organizations for people living with obesity. They obtained responses from 408 adult respondents who, on average, had been living with obesity for 27 years. They were mostly (94 percent) females.

Among these women, 98 percent reported experiencing stigmatizing experiences. In adulthood 95 percent had such experiences, in adolescence it was 90 percent, and in childhood it was 75 percent. Most often, this was verbal mistreatment, in public, and strangers were most often the source of it. Not good.

Half of HCPs in Bariatric Surgery

Equally disturbing is the data from Abbott et al. These researchers found evidence of implicit weight bias in half of the HCPs who participated in a webinar and completed an assessment for it. Clearly they know weight bias is a problem. Most of them (90 percent) agreed that obesity services are too weight focused. Nearly as many (86 percent) agreed that the ritual of weighing at every appointment was problematic.

Most of these HCPs were dietitians and psychologists. They clearly have awareness of the problem, but implicit bias is sneaky.

Putting People First

Writing in Primary Care: Clinics in Office Practice, Nina Crowley tells us this situation must change because of the impact internalized bias has on mental health. She recommends treatment strategies that unwaveringly put patients first. Token efforts will not have an impact. Everything a clinical practice does needs to start with and center upon the needs of the patient, informed by an understanding of the complex disease of obesity.

This is a tall order. But anything less creates the risk that clinicians will fall short of their obligation to do no harm.

Click here for the Muscogiuri study, here for the Abbott study, and here for the Crowley paper.

The Enigma, painting by Gustave Dore / WikiArt

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December 19, 2022

3 Responses to “Weight Bias Not a Problem Here? Think Again”

  1. December 19, 2022 at 8:42 am, Angie Golden said:

    Thank you for this reminder. I just reviewed papers for a prestigious company and found so much bias in the language of the papers! It made me sad and some were quotes from obesity expert physicians :(. We all have to be aware and it can start with our language. People first language ALWAYS

  2. December 20, 2022 at 7:07 am, ELIZABETH SCHULTZ said:

    This commentary identifies those struggling w obesity – the same social/institutional bias with inherent mental anguish exists for individuals struggling w low weight. .

    • December 20, 2022 at 8:59 am, Ted said:

      You are so right, Elizabeth, and for some people, the struggle part of it comes mainly from coping with judgmental attitudes of other people.