Weight Bias in Healthcare

Healthcare is an amazing field. Every day is unique, filled with different people and exciting things. Some days are interesting and filled with stories to be told later over the dinner table. Others are sad, filled with tears that you hold inside until you reach your car, and then can’t help but let them roll down your face and weep. There are days where your heart goes out to your patients as though they were your own family. And others where you’re practically running out the door to get away from the craziness.

People in healthcare have these highs and lows daily, weekly, yearly. As we have more experiences, we gain the ability and intuition to read a situation quickly. We become immune to the mundane and weird and wacky things become the norm. We develop the ability to quickly judge a patient based on our experiences and, in some cases, we develop a biased approach. Some say with only 15-20 minutes per patient, we’re almost forced to pre-judge people in order to save time.

WAIT, what?! This is a HUGE problem! Healthcare providers should NEVER forget that people are people, and everyone is unique. We cannot let ourselves develop biased attitudes towards ANY group of people. Doesn’t everyone deserve quality care?

Well, according to research, overweight and obese patients bear the brunt of this bias. A recent article out from the New York Times suggests that doctors blame many health conditions on excess weight, even when weight is not the culprit of the problems. The article even gives examples where doctors did not investigate other causes for serious symptoms (such as sudden shortness of breath) due to the patient’s weight.

Graph showing world obesity rates by country.
World wide obesity rates by country.

The article goes on to explain that many specialized bariatric hospitals don’t have the necessary equipment to fully care for obese patients. Surgeons can refuse to do surgery on obese patients due to safety concerns and higher risk to the patient. Many hospitals and surgeons are reluctant to perform surgeries due to quality markers needed for reimbursement from state and federal agencies such as Medicare and Medicaid. Higher risk patients lead to more complications and lower quality scores, leading many hospitals to turn people away. But how can this be justified?? Again, doesn’t everyone deserve quality care?

Another article by Anesthesia LLC  shows that anesthesiologists are not immune to this same bias. In a survey by Medscape, 62% of emergency medicine physicians and 44% of anesthesiologists reported having biases towards certain groups of patients. These are physicians who are WILLING to admit they have biases! Think about how many more physicians who actually HAVE biases who aren’t willing to admit it!!

According to these articles, obese patients are less likely to trust their doctors due to fear of bias. They feel as though they are not being “fat-shamed” and treated unfairly, and studies show doctors are 35% less likely to treat obese patients with empathy and concern. How are you supposed to trust someone who doesn’t treat you like they actually care about your wellbeing?

Courtesy of DrLinda-MD.com
Courtesy of DrLinda-MD.com

Many doctors understand that obesity increases a person’s risk for other health concerns and increases the cost of healthcare. If this is your argument for a bias against obese patients, then you have it all wrong. You should be biased TOWARDS helping those who are overweight regain their health. Shouldn’t we, as providers, do MORE to help people regain their health and wellbeing? Let’s start by seeing the person inside the body. Let’s start by listening.

Let’s start by caring!!

Please…for your own wellbeing…find a provider who cares! There are lots of duds out there (I’ve definitely had a few of my own!) but there are also thousands of doctors who truly care about you and your health. If you don’t like your doctor, if you can’t tell them all your health concerns or feel as though your concerns are being brushed aside, please…keep looking. Find a provider you are comfortable with who treats you like family. Find a provider who listens. You are putting your health and your life into someone else’s hands…make sure you can trust them before you do so.

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