Healthcare Professional Bias Against the Obese: How Do We Know If We Have a Problem?

Abstract

ABSTRACT OBJECTIVES Obesity management will be critical for reducing both the incidence and consequences of diabetes in Canada. However, bias against the obese on the part of healthcare providers may be a barrier to the development of interventions for achieving this as-yet elusive goal. METHOD In this study, we assessed the presence of bias by using an implicit assessment methodology, in which bias is indirectly measured by assessing the degree of interference when participants categorize a set of value-laden words paired with the phrases Thin People and Fat People. A total of 78 healthcare providers provided informed consent and completed the Implicit Attitudes Test as the first activity of the day at an obesity symposium held at an urban tertiary care academic hospital. RESULTS The data showed strong evidence for the presence of a bias against the obese. The obese were seen as bad, lazy, stupid and worthless relative to thin people. The extent of bias did not differ with respect to profession, age of respondent or years of experience. Interestingly, although statistical significance was not reached, there was a trend for obese participants to show less bias. CONCLUSIONS These data call to our attention the importance of recognizing the subtle way that bias against the obese may intrude into the judgments of professionals — even those with an expressed interest in obesity management. Steps need to be taken to reduce the risk of bias negatively influencing the development of sensitive and effective interventions for obesity management.