mental health professionals that treat eating disorders harbour prejudice
against the obese, a new study suggests.
bias has been documented among different groups of health providers like
doctors, nurses and medical students, so there is no reason to expect that
professionals who treat eating disorders would be immune to the same
bias," lead researcher Rebecca Puhl of the Rudd Centre for Food Policy and
Obesity at Yale University in New Haven, Connecticut, said.
against excess weight is considered socially acceptable and is rarely
challenged, she said. Since therapists who treat patients with eating disorders
likely see people who have been bullied or victimised for their weight, bias in
the therapist could be especially damaging and could hinder treatment, Puhl
told Reuters Health.
Close to 4%
of girls and women have an eating disorder – including anorexia, bulimia or
binge eating disorder – at some point in their life, according to the National
Institute of Mental Health. Among boys and men, the rate is a bit under 2%.
For the new
study, more than 300 professionals that treat eating disorders completed
anonymous online questionnaires. The surveys assessed explicit weight bias and
attitudes toward treating obese patients.
Half of the
professionals reported hearing other people in their field make negative
comments about obese patients. Another 42 % believed providers that treat
eating disorders often have negative stereotypes about obese patients,
according to findings published in the International Journal of Eating
In addition, 42%of respondents believed obese
patients weren't motivated to improve their diets and 64% believed these
patients were not following treatment recommendations, Puhl said. Weight bias
can lead to doctors communicating in a condescending tone and making inaccurate
assumptions about a patient's abilities or struggles, Puhl said.
It can also
influence how much time or effort doctors or therapists spend trying to help a
patient. Biases like these can be conveyed in subtle, often non-verbal ways,
like interacting with less warmth and fewer smiles, said Janice Sabin of the
University of Washington in Seattle, who has studied weight bias among doctors
but didn't participate in the new research.
seeing a professional with weight bias may start to feel ashamed and stop
seeking treatment, or feel depressed or anxious, which can impair treatment,
Puhl said. She said people can look to a trusted friend or family member for
support and seek out a therapist who doesn't make them uncomfortable.
should avoid seeking treatment from therapists who may hold prejudice against
people with obesity," Angelina Sutin, who studies psychological well-being
at Florida State University College of Medicine in Tallahassee, said.
Empathy training programmes
many therapists are competent professionals that can provide quality care,"
Sutin, who wasn't involved in the new research, told Reuters Health."If
possible, talk to any friends, acquaintances, or any other contacts about the
proposed provider," she said.
good recommendation can go a long way."Sabin said that for patients, being
honest and "letting a provider know when they are feeling negative
attitudes from the provider" can also be helpful.
professionals, the researchers agreed just being aware of these biases is the
most important step. Some suggested institutions could offer sensitivity or
empathy training programmes as continuing education for health professionals.
bias is a significant public health issue, and it impairs our ability to
effectively prevent and treat obesity and eating disorders," Puhl
said."In many health domains, weight bias just isn't on the radar. That
needs to change."