Even health professionals who treat obesity are biased against overweight patients

September 25, 2003

New Haven, Conn. -- Obesity specialists from physicians and researchers to pharmacologists and psychologists, showed significant anti-fat bias according to a recent Yale study.

"The stigma of obesity is so strong that even those most knowledgeable about the condition infer that obese people have blameworthy behavioral characteristics that contribute to their problem, i.e. being lazy," said Marlene Schwartz, associate research scientist in the Deparment of Psychology and lead researcher of the study published this month in the journal, Obesity Research. "Furthermore, these biases extend to core characteristics of intelligence and personal worth."

"On both implicit and explicit measures, health professionals associated the stereotypes lazy, stupid and worthless with obese people," she said. There also was a significant relationship between age and bias; younger people show greater bias.

She said the findings were particularly noteworthy since the sample was comprised of professionals who treat and study obesity, a group that understands that obesity results from genetic and environmental factors and is not simply a function of individual behavior.

The study extended earlier research by identifying predictors of bias level. Health professionals who work directly with obese patients showed less bias than those who did not. In addition, feelings of understanding the experience of obesity and having obese friends were associated with lower levels of bias.

The study included health professionals attending the opening session of an international obesity conference in Quebec City. Three hundred eighty nine clinicians and researchers were given the Implicit Associations Test (IAT) and a self-report questionnaire assessing explicit attitudes, personal experiences with obesity, and demographic characteristics.

The IAT is a timed measure of automatic associations. It was used in this study to assess overall implicit weight bias, associating "obese people" with "bad" and "thin people" with "good," as well as three ranges of stereotypes: lazy-motivated, smart-stupid, and valuable worthless. The questionnaire assessed explicit bias on the same criteria, along with personal and professional experiences with obesity.
Co-authors included Kelly Brownell of Yale, as well as Heather Chambliss and Steven Blair of the Cooper Institute in Dallas, and Charles Billington of the Minneapolis Vererans Affairs Medical Center.

The study was funded by the Rudd Institute.

Citation: Obesity Research, Vol. 11: 1033-1039 (September 2003)

Yale University

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