Doctors and Therapists Have Unconscious Bias Towards Fat Patients
These issues are on my mind because I have an appointment with a dermatologist tomorrow and I haven't seen this doctor before. These articles explain why every fat patient is apprehensive when they encounter a new doctor. I've even read about the concerns of a fat medical student who encounters bias in her studies. Doctors are part of the same fat-hating culture as the rest of us and are subject to the same conditioning regarding race, weight, disability, gender, age and sexual orientation. I've read that this isn't being addressed in medical school (perhaps that differs from school to school, I don't know). It should be.
I've written before about other types of medical bias. In particular, studies show that black people--even children--are under-medicated for pain in the ER or after surgery. There's a stereotype that they feel less pain or are tougher in some way--all unconscious. I have no words for how much this horrifies me.
Is My Doctor Fat Phobic
Excerpt:
Just like the rest of Americans, healthcare providers carry weight biases. That means that your physician, nurse, dietician, psychologist, and fitness professional may hold discriminatory attitudes about fat people. Studies consistently document weight bias in healthcare providers, including the tendency to view obese* patients as lazy, lacking in self-control, undisciplined, and noncompliant with treatment.
I Had Cancer - And Medical Fat-Shaming Could Have Killed Me
Excerpt:
When my surgeon told me a diagnosis five years prior could’ve saved my lung, I remember a feeling of complete and utter rage. Because I remembered the five years I spent looking for some kind of reason why I was always coughing, always sick. Most of all, I remembered being consistently told that the reason I was sick was because I was fat.
My doctors treated my fat, rather than investigating the real reason I was sick, and it could’ve killed me.
Many therapists and health professionals hold hidden biases toward their obese patients, studies find.
Excerpt:
Also, it appears that weight influences patient diagnosis and treatment. In one study, Davis-Coelho found that therapists were more likely to diagnose an eating disorder for fat clients and cite "improve body image" and "increase sexual satisfaction" as treatment goals--even when the clients did not mention sexual difficulties--than for average-weight clients.
NAAFA: Healthcare Discrimination
NAAFA: Guidelines for Healthcare Providers--PDF
https://www.naafaonline.com/dev2/about/Brochures/NAAFA_Guidelines_for_Healthcare_Providers.pdf
Excerpt:
DIAGNOSING MEDICAL PROBLEMS
• Respect the patient’s health care priorities and address their chief complaint.
• Avoid offering unsolicited weight loss information.
• Remember to perform the same diagnostic tests on your fat patients you would on any other patients for a suspected condition.
• Counsel patients about exercise without linking it to weight. Increased activity improves blood pressure and glucose control, decreases arthritis symptoms and increases overall well-being.
TREATING MEDICAL PROBLEMS
• Do not assume that weight is the cause of all symptoms.
• Do not delay treatment or insist that your patient lose weight prior to receiving treatment.
• Demonstrate care in ordering medication dosages. Some patients react sensitively to small dosages of some drugs, while other drugs require a higher dosage, due to the patient’s higher weight.
• Offer to revisit medication decisions if needed, and explain that treatment can prevent long-term complications.
I've written before about other types of medical bias. In particular, studies show that black people--even children--are under-medicated for pain in the ER or after surgery. There's a stereotype that they feel less pain or are tougher in some way--all unconscious. I have no words for how much this horrifies me.
Is My Doctor Fat Phobic
Excerpt:
Just like the rest of Americans, healthcare providers carry weight biases. That means that your physician, nurse, dietician, psychologist, and fitness professional may hold discriminatory attitudes about fat people. Studies consistently document weight bias in healthcare providers, including the tendency to view obese* patients as lazy, lacking in self-control, undisciplined, and noncompliant with treatment.
I Had Cancer - And Medical Fat-Shaming Could Have Killed Me
Excerpt:
When my surgeon told me a diagnosis five years prior could’ve saved my lung, I remember a feeling of complete and utter rage. Because I remembered the five years I spent looking for some kind of reason why I was always coughing, always sick. Most of all, I remembered being consistently told that the reason I was sick was because I was fat.
My doctors treated my fat, rather than investigating the real reason I was sick, and it could’ve killed me.
Many therapists and health professionals hold hidden biases toward their obese patients, studies find.
Excerpt:
Also, it appears that weight influences patient diagnosis and treatment. In one study, Davis-Coelho found that therapists were more likely to diagnose an eating disorder for fat clients and cite "improve body image" and "increase sexual satisfaction" as treatment goals--even when the clients did not mention sexual difficulties--than for average-weight clients.
NAAFA: Healthcare Discrimination
NAAFA: Guidelines for Healthcare Providers--PDF
https://www.naafaonline.com/dev2/about/Brochures/NAAFA_Guidelines_for_Healthcare_Providers.pdf
Excerpt:
DIAGNOSING MEDICAL PROBLEMS
• Respect the patient’s health care priorities and address their chief complaint.
• Avoid offering unsolicited weight loss information.
• Remember to perform the same diagnostic tests on your fat patients you would on any other patients for a suspected condition.
• Counsel patients about exercise without linking it to weight. Increased activity improves blood pressure and glucose control, decreases arthritis symptoms and increases overall well-being.
TREATING MEDICAL PROBLEMS
• Do not assume that weight is the cause of all symptoms.
• Do not delay treatment or insist that your patient lose weight prior to receiving treatment.
• Demonstrate care in ordering medication dosages. Some patients react sensitively to small dosages of some drugs, while other drugs require a higher dosage, due to the patient’s higher weight.
• Offer to revisit medication decisions if needed, and explain that treatment can prevent long-term complications.