Forgot your password?
typodupeerror
Medicine Education Science

Med Students Unaware of Their Bias Against Obese Patients 446

Posted by Soulskill
from the still-angry-that-santa-isn't-real dept.
An anonymous reader sends news of a study which found that "two out of five medical students have an unconscious bias against obese people." The study, published in the Journal of Academic Medicine (abstract) examined med students from many different cultural and geographical backgrounds. "The researchers used a computer program called the Weight Implicit Association Test (IAT) to measures students’ unconscious preferences for 'fat' or 'thin' individuals. Students also answered a survey assessing their conscious weight-related preferences. The authors determined if the students were aware of their bias by seeing if their IAT results matched their stated preferences. Overall, 39 percent of medical students had a moderate to strong unconscious anti-fat bias as compared to 17 percent who had a moderate to strong anti-thin bias. Less than 25 percent of students were aware of their biases. '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 the two-thirds of American adults who are now overweight or obese,' Miller said. 'Medical schools should address weight bias as part of a comprehensive obesity curriculum.'"
This discussion has been archived. No new comments can be posted.

Med Students Unaware of Their Bias Against Obese Patients

Comments Filter:
  • As of this posting, the vast majority of ACs took the opportunity to make disparaging comments about the overweight. Classy.

  • Fat Hatred (Score:3, Insightful)

    by WOOFYGOOFY (1334993) on Saturday May 25, 2013 @05:09PM (#43823591)

    Fat hatred and blaming people for being fat is so universal and so conscious that it's hard to take any methodolgy seriously that finds that people are "unconscious" of their hatred of obese people.

    Want to get at the real socially redeeming value of this journal entry? Study the methodolgy, understand where it went wrong, and above all never, ever use it.

    • Re: (Score:2, Insightful)

      I "blame" fat people for being fat for the same reason I blame criminals for being criminals ... not because I don't recognize hereditary and environmental aspects, but because the concept of personal responsibility is rather important to a functioning society.

      PS. if they don't feel self pithy, aren't fat enough to suffer health problems and don't care that I find it ugly then I don't really blame them ... it's just a lifestyle choice which doesn't really impact me.

      • Re:Fat Hatred (Score:4, Informative)

        by AmiMoJo (196126) * <mojo@@@world3...net> on Saturday May 25, 2013 @06:48PM (#43824141) Homepage

        I'm not quite obese but I am overweight, and it's because I suffer from two conditions (CFS and arthritis) that making losing weight extremely difficult. It isn't a lifestyle choice, and before these two things got bad I was able to stay fairly trim.

        I feel bad. I don't like the way I look. Thing is though, it really isn't my fault. I wish it was because then I could do something about it.

        Don't make assumptions about people you don't know.

        • Re: (Score:3, Interesting)

          by Anonymous Coward

          I have CFS too so I know what you're going through, I've been overweight because of it as well, but I've recently found one thing that has allowed me to lose weight and actually become healthier. There is only one diet that has worked, and it's basically a variant of low carb, it's called Keto(ketosis) and I've lost 50 pounds in a year from it, and all I've done is changed my diet. I don't exercise more than I already do (sometimes not at all), I don't starve, and I don't have to go without eating or skip m

        • Bullshit. I'm sorry but both of those diseases are excuses, not causes for you being overweight. Swimming would be excellent for you, if you can't afford it the YMCA offers free programs for those that can't. I donate regularly. If in the end you can't exercise, then eat less. That's your choice. I've been to Africa, I've seen people with far worse diseases than CFS and arthritis and they sure as fuck weren't overweight. The only fat people there were rich people... because they could afford western food. I

      • I "blame" fat people for being fat for the same reason I blame criminals for being criminals

        It's interesting that you compare fat people with criminals. What next, people who talk obnoxiously loud in restaurants are like perpetrators of genocide?

        it's just a lifestyle choice which doesn't really impact me

        How generous of you to include that as an afterthought. You forgot to mention that that's the important difference between fat people and criminals. BTW, even people who are fat enough to cause health problems are not your problem. They have lower lifetime healthcare costs.

  • ..and having a bias for thinking so is a bias in this study.
    can't blame them though. because people who stay obese can't follow a diet, obviously. too thin people might have some "respectable" reason for being unable to digest or eat enough, it's much harder to eat on purpose more to gain weight than it is to lose it - the other just needs you not to buy food and put it in your mouth and chew it while the other needs you to have appetite to be able to put it in your stomach and the stomach to be able to dig

    • by hedwards (940851) on Saturday May 25, 2013 @06:33PM (#43824043)

      It's slightly complicated by all the bad advice that's given on how to manage ones weight.

      However, when all is said and done, eating less and moving more solves the problem for most people. Sometimes there's a need to fix ones sleep and or stress in order to lose the weight.

      But, doctors themselves are a terrible source of information on diet and exercise. Unless it's changed recently, they only get a few weeks of training on diet and none on exercise.

  • by Anonymous Coward on Saturday May 25, 2013 @05:11PM (#43823601)

    I'm not unaware. I know exactly what I think about fat people and It's not good.

    • by Anonymous Coward on Saturday May 25, 2013 @06:34PM (#43824049)

      I'm not unaware. I know exactly what I think about fat people and It's not good.

      Juvenile. Also typical of a culture that can't grasp simple concepts like bias affecting treatment, or the amount of time you choose to spend with a particular patient, or whatever. In the modern American conservative mindset, every single thing wrong with every single person is absolutely and completely the fault of some moral failing that person has, because the alternative might mean that religion/corporations/capitalism/etc. aren't perfect and that makes their brains tilt like an abused pinball machine.

      Poor people are poor because they're lazy and don't want to work. Fat people are fat because they won't stop eating. People only get fired from their jobs because of something they did wrong. People who are arrested for crimes are always guilty because the police would never arrest an innocent person. The rich are job creators.

      All of those statements are sometimes true. Some of them are true more than false, and others not so much. The thing is, they are not always true. They are not always false, but with way too many people it's black/white, this/that, on/off, binary reasoning. "I oppose this because somebody I don't like is in favor of it" (the current operating model of the House of Representatives, for instance). "This can't be true because it has to do with emotional parts of the brain and emotions are for left wing communist socialist hippies, unless of course the emotion in question is anger in which case it's OK for me." pretty much describes a decent number of the postings on this topic too.

      The merest hint that people might not be perfect logical reasoning machines AND that sometimes they do things or think things without meaning to is an alien concept because it isn't binary, it isn't simple, and it doesn't fit in a conservative sound byte. Just another example of why our society is crumbling rapidly.

  • but I couldn't eat a whole one
  • is a real thing. Despite how well my mother's bloodwork was all through chemo her doctor kept telling her to lose weight. She was doing amazingly well for someone on chemo and over and over all they could talk about was her weight. It's ridiculous.
  • by Anonymous Coward

    than doctors having a bias against smokers, recreational drug abusers, sex addicts with lots of partners, etc? Each of these groups are doing things that is typically detrimental to one's health, so there seems to be an issue of self control there.

    • sex addicts with lots of partners, etc?

      I never got that, in what way is having lots of sex detrimental to the health or well being of a person? Seems like puritanism masquerading as medicine, a bit like circumcision which is meant to stop young men masturbating.

      I don't care if you don't like it, that's how it is.

      • by hedwards (940851)

        If you're talking about a sex addict, then it definitely is detrimental to their health. And yes, it does have very real consequences. These aren't just people who like to sleep around, these are people who sleep around because they can't stop it. And it does ruin marriages, assuming they can get a partner in the first place. Increased risk of STIs and accidental pregnancy.

        So, no, the isn't a matter of puritanism, there are very real consequences to sex addiction and trivializing it does nothing to help the

      • sex addicts with lots of partners, etc?

        I never got that, in what way is having lots of sex detrimental to the health or well being of a person?

        Nothing really unhealthy about having lots of sex. Having lots of different sex *partners*, on the other hand, will make it rather difficult to avoid STDs.

        • ...unless you use condoms? See this is the kind of comment that makes me immediately wary of people talking about 'sex addicition'.

          • ...unless you use condoms?

            Condoms help. In some cases, such as AIDS, they help a lot. In other cases, like syphilis or HPV, they are far from foolproof, because some STDs do not require contact with infected semen to spread. They still help some, but if you're relying on condoms as your one line of defense while having lots of partners, you're in for a nasty surprise.

    • than doctors having a bias against smokers, recreational drug abusers, sex addicts with lots of partners, etc? Each of these groups are doing things that is typically detrimental to one's health, so there seems to be an issue of self control there.

      I suspect that the problem arises when a given bias impairs the doctor's ability to do diagnostics properly. In some cases(as long as they can avoid being overtly unprofessional about it) the effect is probably minimal: even if your emotions lead you to over-estimate the STD risk of somebody with lots of sex partners, the odds are still pretty good that, if they bother to come and see you, their problem will either be an STD, a different flavor of infection that the standard labs you'd do for a suspected ST

    • Exactly correct. It's like the politically correct mafia that also wants us to "feel" for the poor addicts who continue to use drugs when they ought to know better, or the parents of kids who die from drug overdoses and go out of their way to blame the drug dealers for their kids' deaths, rather than realize that their kids had everything to do with their ingestion of drugs.

      It's not that there is or even whether there is a bias against obese people: doctors in general ought to have a bias against obesity i

  • Compassion (Score:5, Informative)

    by Dunbal (464142) * on Saturday May 25, 2013 @05:16PM (#43823639)
    Compassion is supposed to be a hallmark trait of the medical profession. Any doctor who lets his personal beliefs get in the way of his practicing medicine in the best possible way to ANY patient - be s/he fat, thin, muslim, atheist, black, green, prisoner, retarded, or just an average joe - is a bad doctor. If a patient is obese then yes, it poses a serious health risk and a problem. My job as a doctor is not to lecture that patient or make fun of them, but to try to help them as much as I can with the tools I have at my disposal. The same for alcoholics, drug addicts, and anyone else. Because at the end of the day said behavior is usually just a symptom of a different, underlying problem.
    • Compassion is supposed to be a hallmark trait of the medical profession.

      Compassion and bias are not mutually exclusive. And, "bias" is not always unfounded.

    • by ceoyoyo (59147)

      Absolutely. This study isn't about that. They used a sensitive test for bias. If you don't like fat people (like the majority of the population) then you'll likely test positive. That has nothing to do with how you treat fat people. What they're saying is that med students should be taught about anti-fat bias to make sure that, despite their quite natural biases, they're treating fat people well. They're already taught to manage their biases against assholes, mass murderers and other difficult patient

  • Implicit Association (Score:5, Informative)

    by CanadianRealist (1258974) on Saturday May 25, 2013 @05:18PM (#43823651)

    For those not familiar with implicit association tests, they are based on measuring your reaction times when matching certain types of data according to different specified criteria. For example a gender association test might measure time for matching gender with staying at home raising children versus working outside the home.

    Harvard has plenty of sample tests. [harvard.edu]

    Having taken some of the tests I can say that the results can be quite surprising and point out biases that you are unaware of. I definitely found that some associations were much easier for me than others. (Happy to say that the gender example above was not a problem for me.)

    • by WillKemp (1338605)

      Having taken some of the tests I can say that the results can be quite surprising and point out biases that you are unaware of.

      But in this case were they unaware of their biases or just not prepared to admit to them?

      • I can really only answer for myself, which is what that statement was about. I found out that I had biases that I was not aware of. At least some associations gave me much more trouble than other ones did, and I don't have any other explanation for that. For some I didn't even need to see the reported times, I was aware of the difference while doing the test.

        Maybe everyone else is aware of their biases and is simply not willing to admit them, but I doubt that. I suspect that for these biases:

        reality >

    • by devwild (2314146)
      Thanks for this info, it would be nicer if the article was clearer on what it meant by bias. It's not what they think about obesity, it's what they associate with it, and that's an important difference.

      I like to think of myself as a fair person, but I'd probably have at least a mild bias as well. I've had a lot of friends and family who have had and struggle with obesity in different ways, and had associated health problems (my father died of a heart attacked and spent his life dealing with health compl
  • The fact that people don't admit to their preference doesn't make that preference unconscious. From the journal article:

    [......] possible answers on a seven-point
    Likert scale ranging from “I (strongly)
    (moderately) (slightly) prefer fat people
    to thin people” to “I like thin people
    and fat people equally” to “I (slightly)
    (moderately) (strongly) prefer thin
    people to fat people.”

    That doesn't seem like a very sophisticated way of assessing someone's unconscious feelings.

    • You're ignoring the part about the implicit association test. See my post above. [slashdot.org]

      I agree that what someone admits to doesn't say anything about unconscious feelings. But an IAT can demonstrate feelings that you're not even aware of.

      • by WillKemp (1338605)

        Yeah, of course. But (and i admit i didn't read the whole paper), the point seems to be comparing the results of the IAT with the answers to the preference questions. If the answers to the preference questions are lies, it means nothing.

        • You raise a valid point. My reply was about assessing their unconscious feelings. Maybe it would be better to say that they are unaware of their bias, or even worse are willing to lie about it.
        • by Rockoon (1252108)

          If the answers to the preference questions are lies, it means nothing.

          Its complete fools like you that think your are safe from being tracked by Google/Facebook/Whatever because you lie about shit.

          The fact is that it doesnt matter even if 100% of people are intentionally lying.

  • anti-fat stigma (Score:4, Insightful)

    by Pinky's Brain (1158667) on Saturday May 25, 2013 @05:24PM (#43823677)

    "anti-fat stigma is so prevalent and a significant barrier to the treatment of obesity"

    Being fat-positive would help with the treatment of obesity?

    • "anti-fat stigma is so prevalent and a significant barrier to the treatment of obesity"

      Being fat-positive would help with the treatment of obesity?

      You can't treat a patient you never see. If you know the doctor is just gonna nag you to lose weight again, why would you go back?

      • by ceoyoyo (59147)

        Because you want to be healthier?

      • by Rockoon (1252108)

        You can't treat a patient you never see. If you know the doctor is just gonna nag you to lose weight again, why would you go back?

        Exactly. If when you go to the doctor for something unrelated to weight they spend over half the time talking about your weight, then the next time you have an issue that also isnt related to weight they will obviously again spend over half the time talking about your weight.

        They do it because its easy. Its become part of their script even when there is a complete lack of any health issues related to weight present in the patient, even when obviously the patient doesnt even have a weight problem but simp

        • Co-worker had recently had a C-section get infected, and the doctor nagged her about her weight. She just gave birth you lazy cocksucker!

          Not lazy, incompetent. Possibly also diverting the focus from that fact that they fucked up her C-section.

      • by geekmux (1040042)

        "anti-fat stigma is so prevalent and a significant barrier to the treatment of obesity"

        Being fat-positive would help with the treatment of obesity?

        You can't treat a patient you never see. If you know the doctor is just gonna nag you to lose weight again, why would you go back?

        Yeah, it's a real bitch when your doctor is honest, isn't it...

        I suppose we should just start contacting Hollywood now to see if they want to play the part of doctor. Apparently the truth is just too hard to handle.

    • by AmiMoJo (196126) *

      Obesity is a medical problem but not always a sign that the person has poor willpower or doesn't look after themselves.

      I struggle with my weight a bit, and it's because I suffer from CFS and Reactive Arthritis. My doctor is a dick. When I ask for help he just blames me for not doing enough. He probably does see a lot of patients who just want an easy way to loose weight with no effort, and this bias means I am having to go around him to get any treatment. Needless to say I am switching doctor.

    • "anti-fat stigma is so prevalent and a significant barrier to the treatment of obesity"

      Being fat-positive would help with the treatment of obesity?

      No. But harboring anti-fat biases can inhibit effective treatment.

      Numerous studies have shown that people with biases against fat people make lots of assumptions -- fat people are lazy, undisciplined, lack willpower, etc. In many (and possibly most) cases, this may be true.

      On the other hand, lots of fat people have other medical issues that contribute to their obesity. Others have factors like mental illness and clinical depression.

      If a doctor assumes that a person is fat simply because he's biased

  • by Anonymous Coward on Saturday May 25, 2013 @05:24PM (#43823681)

    "Doctors are more likely to assume that obese individuals won’t follow treatment plans"

    The primary goal of our treatment plan is often to get them to lose weight to cure their hypertension and type 2 diabetes. It's not a bias if you see the same patient in clinic every few months for years and they continue to gain weight and ignore your recommendations.

    **** ********* M.D. , PGY-4 Resident

    • It's not a bias if you see the same patient in clinic every few months for years and they continue to gain weight and ignore your recommendations.

      If an otherwise healthy obese patient comes to see you for years and this is true, you're right -- it's not a bias.

      However, it is a bias if:

      • You assume every fat person who walks into your office is the same.
      • You assume that the cause of obesity is the same in all such patients.
      • You fail to look for other causes of obesity, including physical problems or mental problems, instead assuming you just need to tell them to "lose weight" and come up with a diet plan. Perhaps there is an underlying cause -- part
  • by mark_reh (2015546) on Saturday May 25, 2013 @05:44PM (#43823779) Journal

    were obese? When my wife was in med school about half the class was obese, a few morbidly so.

    • by ceoyoyo (59147)

      Obese people don't like to look at obese people either. We're evolutionarily programmed to prefer to look at and be around healthy, fit people.

      • by sjames (1099)

        Actually, in other eras, the ideal that everyone assumed we were naturally supposed to appreciate was considerabl;y more padded than today's ideal. In the middle ages, a modern model would probably be seen as grotesque and sickly at best.

  • They get all the care and attention, and healthy people are left out in the cold. Equal treatment for all!

    No, seriously, I don't see a bias against obese patients as a problem. And I say that as someone who's pretty heavy, and by my own hand - the hand putting pizza in my mouth. Despite the laughable number of people who say "they have a glandular condition" or some such, 99.9% of the time obesity is a self inflicted injury. The doctors with this bias are, in fact, ahead of the curve. At the end of our slow

  • I hate sanctimonious people, and that holier-than-thou nonsense is what the prejudice against fat people is about. By prejudice I mean being biased against people with regard to things that have nothing to do with their weight. It does not mean not wanting a fat girlfriend (or in the case of Slashdotters, not fantasizing about having a fat girlfriend), or suspecting that they wouldn't be good on the track team, or even about charging them more for life insurance. It means being biased about the guy two desk

  • by Idarubicin (579475) <allsquiet.hotmail@com> on Saturday May 25, 2013 @06:30PM (#43824019) Journal
    First, I'll note in passing that the 'implicit bias' test found a significant bias against thin people in 17% (52 out of 310) students. While that group is smaller than the group significantly biased against the obese (39%, 121/310), it's by no means small. For every two future doctors out to get you for being fat, there's one that hates you for being thin--but for some reason, it's only the obese patients that get the column inches.

    Second, and by far most intriguing, is the 33% (101/310) of students who openly acknowledged an explicit personal bias. Given that 39% (121/301) were found to have an actual bias on the implicit test, on the surface this result isn't surprising - but the 101 who think they're biased, and the 121 who actually have an implicit bias, don't overlap very closely. Just 40 students who thought they had a bias actually did. The study authors (and the journalists who have summarized their results) decided to frame this in the form of two-thirds of anti-fat students don't know they're biased! It's much more curious, I think, to note that a healthy majority of students who thought they were biased against the obese - 61% (61/101) - actually aren't.

    Indeed, it turns out that there wasn't a significant correlation between believing one was biased and actually having a bias. So why do three out of five students who think they have an anti-fat bias hold that belief mistakenly?

There is no distinction between any AI program and some existent game.

Working...