Are public health students guilty of "fatism"?

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Health care workers are subject to the same human foibles as the rest of the population. But prejudice can get in the way of care, especially when it determines how a health professional decides to work with a patient.

About two thirds of U.S. adults are overweight and about a third of the population is classified as obese. In the past decade, public prejudice against obese people has increased by about two thirds, according to the authors of a new study. And many young public health students are also guilty of "fatism," the new analysis found—but their attitudes can be changed.


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"Weight stigma towards obese patients is very common in health care settings," Rebecca Puhl, of Yale's Rudd Center for Food Policy and Obesity, one of the study's co-authors, said in a prepared statement. In a survey of 159 public health and health promotion students in Australia, the group showed a "strong implicit" prejudice against overweight people. And those who feel discriminated against because of their weight are less likely to exercise, eat more healthfully, stick to weight-loss goals and seek preventive health care, the researchers noted. "Thus, it seems crucial to reduce anti-fat sentiment in health professionals," the researchers wrote in the study, which was published online in Obesity April 15 (Scientific American is part of Nature Publishing Group).

The researchers "were surprised by how few efforts to reduce obesity prejudice or weight stigma had been made, particularly within health professionals who are tasked with treating overweight or obese patients," Kerry O'Brien, of the University of Manchester's School of Psychological Sciences and lead author of the study, said in a prepared statement.

To test the ability of training to reduce the prejudice, the surveyed students were randomly assigned to one of three seven-week tutorial programs. One group learned about the lifestyle-related causes of obesity, such as dietary and exercise habits. Another group learned about the genetic and environmental factors that can contribute to obesity, such as family history and junk food marketing. And a control group attended a seminar about alcohol consumption in young people.

Those in the lifestyle tutorial actually increased their prejudice by 27 percent, but the students who learned about genetic and environmental factors decreased by the same amount.

"People only hear that obesity is due to poor diet and lack of exercise, which implies that obese people are just lazy and gluttonous," O'Brien said. "Those tasked with providing health services to obese people may become frustrated with patients when they do not lose weight following counseling and treatment…Obese people are constantly fighting their physiology and the environment. If professionals keep this in mind it may help in not stigmatizing their clients," O'Brien noted.

Image courtesy of iStockphoto/wlfella

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