Are Doctors Biased Against Obese Patients?

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 ‘thin’ people.

They were also asked to complete a survey assessing their conscious weight related preferences.

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By matching the IAT results with survey results, the researchers determined whether the students were aware of their bias.

Findings were interesting.

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• 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 suggest.

This study can be a step forward to getting obese people a fair deal at least where medical facilities are concerned.

Source-Medindia