A wake up call for dietitians about the obese

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Discrimination and prejudice against the overweight and obese is nothing new -- any heavy person can tell you they’ve faced some form of it in their lives. In one study, overweight women recounted their less-than-satisfactory experiences with healthcare workers. And if we need more reminders, we can always count on Tyra to don a fat suit and let the world know that intolerance is alive and well.

But even people who work with that population may be harboring some bias. A study published in the March issue of the Journal of the American Dietetic Assn., led by a Yale University researcher, found that some people studying to be dietitians may have preconceptions about obese men and women.

Researchers sent surveys to 182 undergraduate dietetics students from various schools across the country to ascertain their attitudes about the obese. Each participant was randomly sent one of four hypothetical patient profiles: an obese man and woman, and a normal-weight man and woman, all generally healthy. Except for gender and weight-related information such as body mass index, weight and percentage of body fat, the profiles were identical.

The students, after reviewing the patient profiles, rated them on a number of topics, such as their perception of the patient and their general feelings about the obese. They were asked to assess how receptive they thought the patient would be to treatment recommendations, how compliant they’d be with treatment, how motivated they’d be to change their diets, and how successful they’d be in making those changes.

The study participants also filled out a ‘Fat Phobia Scale,’ rating adjectives describing obese people (for example, ‘lazy’ or ‘industrious’).

The dietetics students who received the obese patient profiles rated them as being less likely to adhere to treatment recommendations, compared to the normal-weight patients. Those reviewing the obese patient profiles also rated their diet quality poorer, and their health status worse, compared with the normal-weight patients, even though their nutritional and health information was the same.

On the Fat Phobia Scale, a majority of the students thought that obese people were unattractive, had poor self control, were slow, had no endurance, were inactive, liked food, over-ate, were insecure and had low self-esteem.

In the study, the researchers wrote that ‘given the moderate level of fat phobia present in the current sample of dietetics students, and their attributions that obese individuals are less compliant with treatment than thinner individuals, it seems warranted to include stigma-reduction interventions as part of standard dietetics curriculum. Interventions that challenge negative weight-based stereotypes (e.g., that obese patients are lazy or non-compliant), and foster sensitive and empathic communication skills may be particularly useful.’

-- Jeannine Stein