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The 2003 Annual Meeting of the North American Association for the Study of Obesity (NAASO) featured presentations on the latest research in obesity and focused on 4 topic areas: molecular regulation and animal genetics; integrated biology; clinical intervention; and population studies. The emphasis this year was on behavioral and surgical interventions to curb the obesity epidemic, and participants encouraged all healthcare providers to take a closer look at the plight of their patients.
Although most healthcare providers in the United States are acutely aware of the expanding girth of the nation, few have considered the discrimination and bias suffered by the obese in employment, education, and healthcare. Heather A. Chambliss, PhD, The Cooper Institute, Dallas, Texas, reported the results of the Implicit Associations Test (IAT) she administered to 389 researchers and health professionals at the 2001 NAASO meeting. The IAT was used to assess overall implicit weight bias attitudes (associating "obese people" and "thin people" with "bad" vs "good") and 3 types of stereotypes: motivated-lazy, smart-stupid, and valuable-worthless. The questionnaire assessed explicit bias on the same dimensions along with personal and professional experience. Healthcare professionals exhibited a significant pro-thin, anti-fat bias based on the IAT, and the level of bias was associated with several personal characteristics. These characteristics were determined by a demographic questionnaire that was also administered to attendees. Higher levels of anti-fat bias were found among younger professionals, women, those with a more negative outlook on life, those who weighed less, and those who reported having fewer obese friends. Dr. Chambliss concluded by saying that there is a strong weight bias even among professionals whose careers deal with research or clinical management of obesity, and this bias contributes to the physical and psychosocial consequences of obesity. Understanding the extent of anti-fat bias and associated personal characteristics will aid in developing intervention strategies to reduce this bias.
Marlene Schwartz, PhD, Yale Center for Eating and Weight Disorders, New Haven, Connecticut, offered some suggestions for healthcare providers in her presentation, "How Can Bias Be Changed?" She asked all healthcare providers to begin by assessing their own offices or clinics by asking questions such as: "Is there easy access for an obese person?"; "Are the chairs appropriate and comfortable?"; "Is the equipment appropriate?" (eg, large blood pressure cuffs, extra-large exam gowns); "Is there a private room to check weight?" She suggested that healthcare providers be sensitive to the obese patient in the following ways:
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