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Overweight Experience Weight Bias From Doctors or Dietitians

A Matched Set
Creative Commons License photo credit: Tobyotter

Weight bias and prejudices coming from medical professionals?  And, especially from dietitians? (let me hide myself here…)!  This leading to clients feeling awful about themselves..even worthless.  This is what I heard from one of my readers recently.

Perhaps this feeling worthless is a self-perception that becomes more sensitive when you are overweight or obese and need to see a doctor or dietitian.  The special reader I connected with was keen to make lifestyle changes to become healthier for herself and her family…she has access to a dietitian at her job to help her achieve this goal.  However, this dietitian made her feel bad about herself.

Because of that she doesn’t use this resource to achieve her goals.  In fact, in our discussion, she pointed out something so apparent I never deeply thought about it before…She said that she (and others she knows) avoids going to doctors too because some of them make you feel so horrible about being a bigger person.  Here is her comment to me, which she said I could share, “do they not think that fat people may be depressed enough ? I know I need to lose weight and all but don’t make me feel like a worthless person because of my size.” I guess I knew biases and ignorant attitudes by health professionals do exist…but I was shocked by how much!  In fact, studies have shown that almost 70% of overweight and obese people have experienced weight bias by doctors and up to 81% of dietetic students have prejudices against the same group. (1,2)

I am sure that there are readers out there that have access to good health care, including doctors and dietitians, but refuse to go because they feel worthless about themselves when they leave the appointment!  What is the problem?  Are overweight people more sensitive to comments in medical consultations or are health professionals lacking in tact and have bias against overweight clients?  Whatever the reasons it happens, the result is that some, perhaps many overweight and obese people who need good medical advice do not seek it because of self-esteem issues.  And as health professionals we must be aware of this and use the proper terms to encourage clients to make healthy lifestyle changes in a positive way.  Because when that client leaves the office, they won’t remember the suggestions on how to successfully lose weight but they will remember how they feel about being overweight.  My question to you readers, have any of you experienced discrimination or untactful words at a health professional’s office?  What was your reaction?  Would love to hear your comments to know the extent of this issue.

(1) Rudd Report, Yale University, 2008

(2) Journal of the American Dietetic Association, March 2009, Volume 109/Number 3   p. 438

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6 Responses to Overweight Experience Weight Bias From Doctors or Dietitians

  1. Vicki July 27, 2011 at 16:59 #

    I can see both sides of this coin, as I am overweight, and am also a Registered Dietitian. And I have definitely seen the bias perpetuated by some of my colleagues. And Samantha hit part of the problem on the head. The “preaching” is part of the probelm. We have a tendency to preach or talk “at” patients under the guise of educating. We have the knoweledge and we want to impart it to the patients. But have we ever taken a step back and asked the patient what they want to learn, if anyting. Overweight people know that theya re overweight and most of them (us) want to lose the weight and make positive changes, but more importantly, we want to be treated as human beings and respected as individuals, not with disdain and disgust. And we as healthcare professionals, should be the first persons to recognize that there are many factors that play a role in someone’s reasons for beign overweight and what different stage of change they may be in.And yes, it can get frustrated when the information we are teaching goes unheeded, but maybe if we start talking with and to instead of at our patients, we may be able to discern what the underlying reason for the resistance is and treat the person not the patient.

    • mbrighton July 31, 2011 at 16:08 #

      Dear Vicki, Thank you so much for your comment and views. You hit the nail on the head. “As healthcare professionals, should be the first persons to recognize that there are many factors that play a role in someone’s reasons for being overweight”. ABSOLUTELY! Keep reading and commenting. Just curious, as you say you are overweight…Do any of your clients have bias against your advice because you are overweight?

  2. Robert Taylor July 26, 2011 at 18:48 #

    “Unnecessary risks are being taken by patients seeking the liberation treatment.” says Dr. Avneesh Gupte of the CCSVI Clinic. “It has been our contention since we started doing minimally invasive venous angioplasties nearly 6 years ago that discharging patients who have had neck vein surgery on an outpatient basis is contra-indicated. We have been keeping patients hospitalized for a week to 10 days as a matter of safety and monitoring them for symptoms. Nobody who has the liberation therapy gets discharged earlier than that. During that time we do daily Doppler Ultrasounds, blood work and blood pressure monitoring among other testing. This has been the safe practice standard that we have adopted and this post-procedure monitoring over 10 days is the subject of our recent study as it relates to CCSVI for MS patients.”

    Although the venous angioplasty therapy on neck veins has been done for MS patients at CCSVI Clinic only for the last 18 months it has been performed on narrow or occluded neck veins for other reasons for many years. “Where we encounter blocked neck veins resulting in a reflux of blood to the brain, we treat it as a disease,” says Gupte. “It’s not normal pathology and we have seen improved health outcomes for patients where we have relieved the condition with minimal occurrences of re-stenosis long-term. We believe that our record of safety and success is due to our post-procedure protocol because we have had to take patients back to the OR to re-treat them in that 10-day period. Otherwise some people could have run into trouble, no question.”

    Calgary MS patient Maralyn Clarke died recently after being treated for CCSVI at Synergy Health Concepts of Newport Beach, California on an outpatient basis. Synergy Health Concepts discharges patients as a rule without in-clinic provisions for follow up and aftercare. Post-procedure, Mrs. Clarke was discharged, checked into a hotel, and suffered a massive bleed in the brain only hours after the procedure. Dr. Joseph Hewett of Synergy Health recently made a cross-Canada tour promoting his clinic for safe, effective treatment of CCSVI for MS patients at public forums in major Canadian cities including Calgary.

    “That just couldn’t happen here, but the sooner we develop written standards and best practices for the liberation procedure and observe them in practice, the safer the MS community will be”, says Dr. Gupte. “The way it is now is just madness. Everyone seems to be taking shortcuts. We know that it is expensive to keep patients in a clinical setting over a single night much less 10 days, but it’s quite absurd to release them the same day they have the procedure. We have always believed it to be unsafe and now it has proven to be unsafe. The thing is, are Synergy Health Concepts and other clinics doing the Liberation Treatment going to be changing their aftercare methods even though they know it is unsafe to release a patient on the same day? The answer is no, even after Mrs. Clarke’s unfortunate and unnecessary death. Therefore, they are not focused on patient safety…it’s become about money only and lives are being put at risk as a result.”

    Joanne Warkentin of Morden Manitoba, an MS patient who recently had both the liberation therapy and stem cell therapy at CCSVI Clinic agrees with Dr. Gupte. “Discharging patients on the same day as the procedure is ridiculous. I was in the hospital being monitored for 12 days before we flew back. People looking for a place to have the therapy must do their homework to find better options. We found CCSVI Clinic and there’s no place on earth that’s better to go for Liberation Therapy at the moment. I have given my complete medical file from CCSVI Clinic over to my Canadian physician for review.” For more information Log on to OR Call on Toll Free: 888-419-6855.

  3. PiterJankovich March 30, 2010 at 18:53 #

    My name is Piter Jankovich. oOnly want to tell, that your blog is really cool
    And want to ask you: is this blog your hobby?
    P.S. Sorry for my bad english

  4. mbrighton February 5, 2010 at 14:42 #

    Dear Samantha,
    Thanks so much for your comment! I know you are in training…but you have an open attitude and compassion..those are some main things that will keep you successful and your clients knowing that you care. Personally, perhaps I am wrong, but I feel that there is also a lot of weight bias here in France. You see less “very large” people, so when you do see someone bigger, you hear the comments around you (or feel the look) that people give to those who are obese. And of course, with children here-same thing.
    In general, here in the SW France, people think if you are obese that you just don’t take care of yourself or eat too much or not expend enough energy! They don’t realize that there are genetic and endocrinological factors that affect weight too. I detest discrimination (at any level…race, sexual preferences, gender and of course weight bias)…and try to fight it! My kids are deeply aware that bigger people are not always that way because they overeat!
    As you enter the field, keep your open mind, but yes, counseling patients on weight loss is one of the most challenging areas in dietetics.

  5. Samantha February 5, 2010 at 00:53 #

    Wow! 70% have experienced weight bias by medical professionals?! I’ve heard that, but would not expect the percent to be so high! It is so important for that patient to feel motivated to tackle their health problems when they leave an appointment. A positive attitude from the doc is a start. I’m sure these med professionals weren’t so biased at one point in their career. From a dietitian’s point of view (or dietetic intern 🙂 ), it can get exhausting preaching the same thing to nearly all patients (bc majority of patients these days are overweight), and not seeing any improvement. Or in some situations, educating patient after patient who claims “I’m not going to change [fill in the blank]”. I would imagine after years and years of preaching, “tough love” (so-to-speak) kicks in, and BAM! A bias is born! Regardless, each patient is an individual and needs to be treated fairly. A medical professional needs to possess a positive attitude, be encouraging, and help the patient set some realistic goals. A patient should not be belittled–that makes me feel so sad for them!!

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