Research finds that two out of five medical students have
a subconscious bias against obese people. This suggests that many obese people
may not be getting proper health care.
The new study from the Wake
Forest Baptist Medical Center indicates medical fraternity to have a prejudice
against obese patients, albeit at a subconscious level. The study published
online in the Journal of Academic Medicine reveals that over one-third of medical students had a significant implicit
anti-fat bias and most of them were not even aware of that bias
"Bias can affect clinical care and the
doctor-patient relationship, and even a patient's willingness or desire to go
see their physician, so it is crucial that we try to deal with any bias during
medical school," said David Miller, associate professor of internal medicine at
Wake Forest Baptist and lead author of the study. "Previous research has shown
that on average, physicians have a strong anti-fat bias similar to that of the
general population. Doctors are more likely to assume that obese individuals
won't follow treatment plans, and they are less likely to respect obese
patients than average weight patients".
The study comes in the wake of updating the
medical school's curriculum on obesity. David Miller and colleagues sought to
determine the prevalence of weight-related biases among medical
students and whether they were aware of their biases.
310 third-year medical students, geographically
representing 13 countries, at Wake Forest School of Medicine in the
southeastern United States participated in the study between 2008 through 2011.
The students were asked
to complete the Weight Implicit Association Test (IAT), a computer
program to measure the deep-rooted (subconscious) preferences for 'fat' or
They were also asked to complete
a survey assessing their conscious weight related preferences.
By matching the IAT results with
survey results, the researchers determined whether the students were aware of
Findings were interesting.
39 percent (121 out of 310) of
medical students had a moderate to strong unconscious anti-fat bias.
17 percent (52 or 310) of
medical students had a moderate to strong anti-thin bias.
Two-thirds of students (67
percent of 121 students) were unaware of their deep rooted anti-fat bias.
No demographic factors
were associated with a subconscious anti-fat bias.
Although the study did not
suggest any strategies to reduce anti fat bias, Miller said, "Because anti-fat
stigma is so prevalent and a significant barrier to the treatment of obesity,
teaching medical students to recognize and mitigate this bias is crucial to
improving the care for obese people". In fact, acknowledging the existence of
such bias is a prerequisite to combating prejudice, he said.
The authors concluded that
'Medical schools' obesity curricula should address weight-related
biases and their potential impact on care'.
The Obesity Society also feels
the same. 'Overweight and obese individuals are often targets of bias and
stigma, and they are vulnerable to negative attitudes in multiple domains of
living including places of employment, educational institutions, medical
facilities, the mass media, and interpersonal relationships,' they note.
They, thus, ask the medical professionals to
identify one's own bias. Asking questions such as 'Do I make assumptions based
only on weight regarding a person's character, intelligence, professional
success, health status, or lifestyle behaviors?' and 'Am I sensitive to the
needs and concerns of obese individuals?' or 'Do I treat the individual or only
the condition?' can be a strategy to approach patients with sensitivity, they
This study can be a step forward to getting obese
people a fair deal at least where medical facilities are concerned.