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Med Students Unaware of Their Bias Against Obese Patients 446

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.'"
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Med Students Unaware of Their Bias Against Obese Patients

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  • 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.

  • by Anonymous Coward on Saturday May 25, 2013 @05:14PM (#43823633)

    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.

  • 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?

  • 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

  • Re:Fat Hatred (Score:2, Insightful)

    by Pinky's Brain ( 1158667 ) on Saturday May 25, 2013 @05:33PM (#43823725)

    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.

  • by Anonymous Coward on Saturday May 25, 2013 @05:38PM (#43823757)

    If I repeatedly hit my penis with a hammer three, four, or even five times per day, every day for years on end, it'd be clear that I have a mental illness.

    If I soaked my scrotum in sulfuric acid three, four or even five times per day, every day for years on end, it'd be clear that I have a mental illness.

    If I burned my glans with a cigarette lighter three, four or even five times per day, every day for years on end, it'd be clear that I have a mental illness.

    Yet if I eat greasy fast food, snacks that are mostly sugar, sodas laden with chemicals and artificial sweeteners, and other food that don't promote good health three, four or even five times per day, every day for years on end, I don't have a mental illness? BULLSHIT!

    Yet if I refuse to even attempt exercise of any sort, even something as simple as walking around, all day, every day, for years on end, I don't have a mental illness? BULLSHIT!

    Aside from a small number of very isolated cases, obese people are obese solely because they show an utter contempt and disrespect for their own bodies and health. It is indeed a mental illness, even if it affects 60% or more of the American population today.

    Don't pretend that obesity isn't a mental illness, because in almost all cases it is exactly that.

  • 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.

  • Re:Compassion (Score:4, Insightful)

    by Dunbal ( 464142 ) * on Saturday May 25, 2013 @05:44PM (#43823783)
    You misunderstand me. It's not about being "snooty", it's about professionalism. And I only speak for myself. Whether I am biased or not stays outside the exam room but first I have to realize that such bias is possible. If I was "snooty" and "special" then I could do no wrong in my own eyes anyway. That's not true. I know I am very human, so I make a special effort NOT to be biased in any way. All patients deserve the best medical care no matter what shape or size. I fail to see what is "snooty" about that attitude.
  • Re:Med students (Score:4, Insightful)

    by GrumpySteen ( 1250194 ) on Saturday May 25, 2013 @06:23PM (#43823963)

    I explained it in simple terms and offered a real life example and you still can't figure out why a doctor that doesn't recognize his biases is a bad thing?

  • 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.

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

    by ebno-10db ( 1459097 ) on Saturday May 25, 2013 @06:46PM (#43824133)

    Citation: []

    It is just a summary but they link to their more official sources. The core values, as quoted from the blog: The lifetime costs were in Euros: Healthy: 281,000 Obese: 250,000 Smokers: 220,000

    So, obesity saves more than 10% of lifetime healthcare cost.

    Thank you! I knew that was true of smokers, but wasn't sure about obesity. Despite silly things like objective data (which Slashdotters otherwise rightly insist on) people will still use "fat people raise my healthcare costs" as an excuse for their sanctimony.

  • by Anonymous Coward on Saturday May 25, 2013 @07:11PM (#43824285)

    Then don't pretend that homosexuality isn't a mental illness, either. Evolution has conditioned us so that the desire to pass on our genes is a strong imperative. If you actively go out of your way to not pass on your genes, to seek partners who are incapable of doing so, then something must be wrong with your mind. On top of that, anal intercourse has a much higher chance of passing on infectious diseases than vaginal intercourse. Regularly having anal sex must be a mental illness then, too.

    Does the above paragraph sound like bullshit? Then stop being a fucking hypocrite. Either both obesity and homosexuality are mental illnesses or neither is. Funny how leftists claim they support alternative lifestyles when in reality they refuse to support alternative lifestyles that are common in red states.

    I'll tell you the TRUTH: my obesity is a deliberate lifestyle choice. I eat greasy food, sugary sodas, and other unhealthy food because they taste good and I enjoy it. Simple as that. My lifestyle is infinitely more important to me than my health. I would rather die young after living a life of fun and taste than waste a long life living like a monk. Now, I have no problems with homosexuality, because I recognize it as an alternative lifestyle just like my own, but go fuck yourself if you consider one person's unhealthy lifestyle choice fine but another's a mental illness.

  • Re:Med students (Score:5, Insightful)

    by AthanasiusKircher ( 1333179 ) on Saturday May 25, 2013 @08:22PM (#43824591)

    *Are* they less likely to follow treatment plans? It stands to reason that someone who won't do what's necessary for his health in one area might be less likely to do so in another area as well.

    Studies have shown that the most common assumption is that fat people are lazy, undisciplined, unwilling to work hard, etc. -- not just in terms of health choices. Your comment is playing directly into that bias.

    I think this bias, like most, actually does have some relationship to reality -- i.e., a greater percentage of fat people are likely to have these traits than others.

    HOWEVER -- pre-judging an individual on the basis of a single characteristic is the very definition of "bias."

    Even if 90% of obese people are lazy bastards who won't even try to listen to their doctor's advice (and I don't think the number is that high), that does not excuse a doctor who provides inferior treatment to the other 10% because of assumptions.

    If the doctors' assumption is accurate, it's not bias in the sense implied.

    That's like saying -- If a black person is driving around a rich neighborhood, he must be looking to steal something -- because "black people are more likely to commit crimes" is an "accurate" statistic.

    Even if X is often correlated with Y, it doesn't justify the assumption that X always implies Y. When dealing with healthcare, these sorts of assumptions can literally be deadly, such as when a physician fails to search for secondary contributory causes of obesity in a particular patient because the assumption is just that the patient must be a lazy bastard who can't follow directions.

  • Re: Med students (Score:5, Insightful)

    by Kell Bengal ( 711123 ) on Saturday May 25, 2013 @10:20PM (#43825029)
    The problem here is that the only signal people have for what their body needs energy-wise is mediated by their hormone balance and brain-chemistry. If you have a condition where even too much energy feels like you're starving (a painful condition), it's readily understandable that you are going to eat too much, even with the best intentions. The problem of simply blaming "eating too much" is that it becomes synonymous with gluttony - a vice and failure of virtue. Even though yes, you are simply eating too much in the thermodynamic sense, it rapidly becomes a stigma where the patient is 'at fault', rather than the underlying medical condition. In this way, victimisation of obese patients is counter-productive.

    Sure some people simply have no self-control - but is that because they are bad people, or because there is some factor at work that makes it hard for them? The blame game for obesity is a bit like accusing people with a birth mark of being in league with the devil and burning them - we should know better by now.
  • Re:Med students (Score:5, Insightful)

    by MikeBabcock ( 65886 ) <> on Sunday May 26, 2013 @12:57AM (#43825533) Homepage Journal

    True story to back this up -- I was 140 lbs at 6'5 in highschool with very bad joints and asthma I sadly seem to have inherited. Both limit my exercise immensely, as does my job in computers.

    Having subsequently moved and having a different doctor now than then and weighing substantially more, I have no new health problems than then but my new doctor upon hearing of my breathing and joint issues blamed my weight and told me to lose it, which obviously won't help, as I had the same problems when clinically under-weight.

    Bias is wrong -- and leads to poor assumptions.

  • Re:Fat Hatred (Score:2, Insightful)

    by ultranova ( 717540 ) on Sunday May 26, 2013 @02:48PM (#43828293)

    When we see a heroine addict we don't mew and cry about the sociological reasons for their addiction. We have to be firm, tell them their continued abuse of drugs is not ok, and we will not abide it. The same should happen with people that are obese. We're enabling them. Fat is not beautiful, it kills you, stop treating it as if it were some sort of unavoidable birth defect. It's a choice, and it's not ok.

    Your implicit asumption that you have a right to tell other people what they may eat or otherwise input into their bodies "for their own good" is not okay. Your continued abuse of your freedom of speech by advocating depriving other people of their freedom is not okay, and we will not abide it. Authoritarianism is not beautifull, it has killed over hundred million people in the last century alone, and you must stop treating it as if it were some sort of unavoidable birth defect. It's a choice, and it's not ok.

    Also, let me tell you a terrible little secret: no one, no matter how fit, gets away alive. No one.

All science is either physics or stamp collecting. -- Ernest Rutherford