Again I write a post aware that it's not exactly food related, but it is close enough & has been bothering me. Here goes...I was pretty annoyed when I read an article awhile ago published by the McGill University Health Centre on weight-bias of nutrition students. The article reported that only 2% of those training in the United States to become dietitians had positive or neutral attitudes towards people who are obese, leaving the remaining 98% being moderately biased against prospective patients. The news article, which was written in response to a research paper published in the March issue of the Journal of the American Dietetic Association outlined the researchers' suggestion that future dietitians are not immune to weight bias, and that negative attitudes towards obese patients may have a direct impact on their quality of care.
So I went to the ADA article to see what exactly was going on here....
Researchers asked 182 undergraduate dietetics students from 14 American universities to respond to questions about a hypothetical patient. Each was randomly assigned the profile of normal-weight male, normal-weight female, obese male or obese female patient. All patients profiled had the same health characteristics (height, blood pressure, cholesterol, blood glucose, physical activity level, fruit & veg intake, fiber intake etc.) except for weight. The students rated the obese patients as being less likely to comply with treatment recommendations compared with non-obese patients. Students also evaluated obese patients' diet quality and health status to be poorer than the non obese patients despite being given equivalent nutritional and health information across weight categories for the male & female profiles. The research findings referenced the unfortunate fact that stereotypes about the noncompliance of obese individuals with medical weight loss treatments have been reported by a range of health care providers...which appears to also include dietetic students
"In the absence of information to suggest that the patient was noncompliant with treatment in the past, it is concerning that [dietetic] students made this assumption based on a patient's body weight. Furthermore, there is no research to suggest that obese patients are less likely to adhere to treatment recommendations than non obese patients"
Such a finding is concerning for me as I agree that "professional insensitivity" is awful! As a nutrition student myself, I've learned that body weight doesn't tell us everything and it reminded me of other awful practices such as weighing children in elementary schools and then sending home report-card-style results. We need to be sensitive to weight issues, and realize that stigmatizing overweight & obese people as lazy and unmotivated will do nothing to help them achieve their weight loss goals in the long run, which is what we are there to do.
I will mention that I am not saying weight doesn't matter...it's just that it ISN'T EVERYTHING! I do want to be cautious of promoting the flip-side 'healthy-obese' argument, that perhaps goes too far the other way stating "that a significant proportion of fat people are metabolically healthy" and are suffering 'benign obesity' which we should not be overly concerned with. The ADA paper calls for improved curriculum for dietetic students to include standard stigma-reducing interventions. I can't comment on American based dietetics programs, but I do know that my education experience has involved professional development courses that have encouraged & promoted the avoidance of such bias for me in my future practice. I wonder how a similar study conducted here in Canada would compare? After all, although it is not as severe as in the US, obesity is still a major issue at home in Canada.
Interestingly, the paper does refer to Canadian practice and reports a recent Canadian study published in 2004 where 80% of 524 dietitians interviewed indicated that they should alter their focus from weight to other indicators of health in managing obesity. Perhaps our next step needs to be moving from recognizing the importance to increasingly implementing weight management practices that unbiased & stigma-free.
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