A doctor’s examination room should be a safe and supportive place where patients of all shapes and sizes receive compassionate care. Sadly, that’s not always the case. Weight bias, which refers to negative attitudes, stereotypes, and discrimination directed toward individuals due to their adiposity, is just as pervasive in the doctor’s office as it is out in the world, research shows.
One study in the International Journal of Obesity found that physicians viewed patients with obesity as less self-disciplined and more “annoying,” and they reported less desire to help them than to help thinner patients. In another study, 24 percent of nurses reported that they felt “repulsed” by patients with obesity and 12 percent reported that they did not want to touch these patients.
That hurts a patient’s sense of well-being and their health too. That’s because patients who feel stigmatized by their physicians and/or medical team end up forgoing visits to avoid judgment, resulting in delayed health care and adverse outcomes.
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The Humiliation of Weight Bias
Weight bias can be as subtle as a nurse’s sneer when she asks a patient to step on the scale, or as obvious as a doctor abruptly cutting short an appointment or attributing all of a patient’s health issues to their weight.
What’s behind their snubs and assumptions? Studies show that some medical professionals harbor false beliefs that obesity is a choice and that patients with obesity are lazy. Hospital gowns that are too small, examination tables that are too narrow, and medical equipment that isn’t appropriately sized add to a patient’s sense of shame and discomfort and may even result in misdiagnoses. (If blood pressure cuffs are too small, for example, they won’t give an accurate reading.)
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The Harmful Effects of Weight Bias
Members of my organization, Obesity Action Coalition (OAC), tell me chilling stories about their encounters with biased medical professionals. The potential consequences are equally terrible. Research shows that individuals who have experienced weight bias are at increased risk for depression, anxiety, low self-esteem, poor body image, substance abuse, and suicidality. They are also more likely to gain weight due to stress eating and other maladaptive behaviors, which leads to more negative feelings and stigma.
Will new GLP-1 medications reduce obesity bias? Possibly, though it’s still too early to tell. What we do know is that obesity is a chronic disease driven by powerful underlying biology — not by choice. By helping others understand the biology behind the disease, OAC believes we can create a society that understands, respects, and accepts its complexities and prioritizes accessible, science-based treatment.
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Should You Speak Up?
Body weight is a highly sensitive issue, and not everyone feels comfortable talking about it, even with their doctors. Even less appealing for most patients is the notion of confronting a doctor or nurse about their weight bias. If you find doctor visits stressful, here are strategies that may help:
Prepare for appointments: Make a list of the issues you want to discuss with your doctor before your visit. By writing down your questions, concerns, and health goals in advance, discussions during your appointment are less likely to veer off track or get cut short.
Be open-minded: If your provider tells you that you need to lose weight to solve a health issue — one that you don’t believe is connected to weight — ask him or her to explain the connection. You might not know it, but conditions like joint pain, for example, could be related.
Practice self-compassion: Acknowledge your past struggles with weight and treat yourself kindly to buffer the negative emotions you feel during a doctor’s appointment.
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Advocate for Yourself
Participate in medical decisions and speak up when you have preferences for certain treatments or diagnostic methods. Bring a trusted family member or friend with you who can serve as an extra set of eyes and ears, and who can make you feel more comfortable.
If you’re too shy to speak up during the appointment, send a note afterward with follow-up questions or a description of why you felt disrespected during the visit. Because bias is often unintentional, the person receiving your feedback might not be aware that they said something hurtful and may be grateful to understand why.
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Switch Doctors
As a last resort, move on and find a doctor who offers you the kind of care you need. Changing doctors is not always easy, but have faith that there are good, compassionate physicians out there with office equipment that is appropriately sized. Ask friends for referrals, read online reviews, or visit the OAC’s Find a Provider portal. While you’re there, check out these additional support tools and resources.
