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Medicine Education Science

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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  • Med students (Score:0, Interesting)

    by Anonymous Coward on Saturday May 25, 2013 @04:56PM (#43823533)

    And you are unaware of your bias against med students, 2 out of 5 makes 40% I don't see how that justifies your title.

  • by Anonymous Coward on Saturday May 25, 2013 @05:15PM (#43823635)

    "Medical schools should address weight bias as part of a comprehensive obesity curriculum."

    Uh, or Americans should stop eating so much and get some exercise once in a while?

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

    by GrumpySteen ( 1250194 ) on Saturday May 25, 2013 @06:07PM (#43823903)

    Well, you completely missed the point. Doctors who don't recognize their biases are more likely to misdiagnose patients that they're biased against.

    Take me, for example. My kidneys failed due to IGA nephropathy, which has absolutely nothing to do with weight. I'm overweight, however, so for the first year of me feeling run down, getting sick often and having other health isuses my doctor insisted that I just needed to lose weight. He never bothered looking for other potential causes because, in his mind, the problem had to be that I was too fat and therefore didn't deserve any further attention.

  • Re:Med students (Score:2, Interesting)

    by Jiro ( 131519 ) on Saturday May 25, 2013 @06:29PM (#43824011)

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

  • by Idarubicin ( 579475 ) 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?

  • Re:Fat and Fit (Score:2, Interesting)

    by Anonymous Coward on Saturday May 25, 2013 @07:29PM (#43824387)

    Hey asswipe monkey brain *I'M* one of the unlucky ones. *I DO* have health reason to be fat. *I DO* have genetic reasons. Oh and there are mental depression reasons too but frankly exercise helps fix those.

    I'm not because I fucking well dont want to be a 10 ton lardass. The real, genuine reason for obesity is that person is just simply too fucking lazy to give a shit. *I'M* the exact reason why lard asses should be given a boot up the arse - if I can do it then so can everyone else. No goddamn excuses - if you are 50 kgs overweight it's *YOUR* fault. Most to lose weight dont need to exercise or watch their diet like I do - to keep myself stable I *need* 50 kms of cycling a day. Think about that - if that doesnt' scream I have issues that I need to overcome when almost all of you cant even think about doing that and you woul be losing plenty of weight then I dont know what does.

    So don't fucking tell me you have genetic or health issues keeping you the size of a small bus. You just cant be bothered to do anything about it and to make that do something a lifestyle.

    Oh I'm sure there's sob stories about no time or no money or whatever. Bullshit. It's excuses. And that's why people are scorned for being fat. It's YOUR CHOICES than made you a land whale. No your health, not your genetics, not your state of wealth or time.

    Fat acceptance? Go fuck yourselves. If I can be a normal size, so can you. STFU and do it.

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

    by DoubleJ1024 ( 1287512 ) on Saturday May 25, 2013 @07:29PM (#43824389)
    I must be one of the lucky few people in the U.S. then. I have two doctors who actually cared enough to get to know me as a person and realize why I have the problems that I have. One of those doctors is my E.N.T. He spent a lot of time and energy clearing up a chronic ear infection and has helped me with some other issues related to my health. The other "doctor" is a nurse practitioner who performed a yearly physical and found that I had a HORRIBLY under-active thyroid that lead to me gaining 30 pounds in just over 4 months. I have spent most of the past year on medication, adjusting the dosage to be correct for my needs. I figure between that and my joining a crossfit gym (if you need to know what it is use some Google fu) I will be loosing most of the weight I have gained. I had a coworker state that I am "unhealthy" because of my weight, yet this same person eats Chinese take out crap 6 days a week, and the other day he eats McDonald/taco bell/fast food and sees nothing wrong with this. He also thinks because he is thin he is in good shape. I have also seen some people who are rail thin, but have an astonishing high problem with diabetes, arthritis, high body fat percentage, and other issues. Yet the doctors tend to take one look at them and say oh you are perfect because you fit the model of health we are taught by the school/government. I have a friend who is overweight, and she knows it. She realizes she has a problem and is working on fixing it with medication, diet, exercise, and a support group. She has a medical condition that was found by a doctor, AFTER she demanded the appropriate tests. Her nutritionist and doctor spent a lot of time going round and round with the results from the test, the doctor did not believe it and thought that diet/exercise was the only reason for the problem. The nutritionist realized that it was a metabolism issue and that it would take some medication in addition to the normal move more, eat less regimen. She physically could not get appropriate nutrition from food, and that lead to eating more to get the required nutrition. This cycle lead to a bunch of other issues, the least of which being weight gain. The medical industry in the U.S. is BROKEN and requires a complete reboot. I have a friend who went to college and graduated with two undergrad degrees and had NO debt. This friend then went to medical school and racked up over three hundred thousand dollars in debt due to tuition, fees and expenses. This is after fighting to get a slot in med. school due to the AMA setting up a limit to how many slots can be made in a given year. He will now be spending the REST OF HIS LIFE paying off student loans from medical school. This same "education" taught outdated skills and minimized critical thinking outside of the industry standards. Thankfully he had an amazing bit of training from his grandparents who were doctors in another country, and knows how to fix things without resorting to over-used, over-priced medications. And he knows what it means to be unconsciously biased against as he is an openly gay man.
  • Re:Fat Hatred (Score:2, Interesting)

    by Anonymous Coward on Saturday May 25, 2013 @08:43PM (#43824675)

    that making losing weight extremely difficult

    Bullshit. Losing weight is just as easy as it used to be. Eat less. That's it.

    You may be thinking of bodyfat percentage instead. Keeping that down is a lot harder with your conditions, true. But overall weight is easy.

  • Re:Fat Hatred (Score:3, Interesting)

    by Anonymous Coward on Saturday May 25, 2013 @11:46PM (#43825283)

    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 meals or anything, I would seriously suggest as a fellow CFSer to try it.

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

    by Belial6 ( 794905 ) on Sunday May 26, 2013 @12:53AM (#43825517)
    There are objective tests. Doctors with a bias won't give them. I went and got hydro-statically weighed. I know that my lean body mass is 169 lbs. My height is 5'11" and at my last physical I was 212 lbs. That put my body fat percentage at 21%. This is at the high end of "ideal". On the other hand, the BMI put me at the high end of "over weight" and only 3 lbs shy of "obese". According to the BMI I should not weigh more than 178 lbs. That would be 5% body fat. This is the point that you start eating into your essential body fat. So, according to the BMI my body fat should be between 5% and -30% body fat. That is right. The BMI says I should be between sick and dead.

    At this physical, my doctor is telling me that I need to lose weight because 212 is "a lot of weight". He didn't car that my body fat % was fine. He just kept pointing out that BMI is "the best indicator of healthy weight". He has a bias against fat people. Even worse, his definition of "fat" is completely twisted and dangerous.

    Even worse is that I have been 5 lbs over weight. 5 lbs overweight isn't even close to obese. It also isn't "some buff slav". But, what I hear is from dumbasses saying "Your not Mr. Universe, so the BMI is correct."

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