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Study Suggests Most Dietitians Stereotype The Obese

dietitian with patientYou would like to think that when people sign up to be a dietitian, they not only have their future clients’ best interests in mind, but that they have a positive outlook. But according to a new study, only two percent of people training to be dietitians have positive – or even neutral – attitudes toward people who are obese.

Um, two percent?

Most of the nearly 200 dietetic students from the study had a negative view about the attractiveness, self-control, overeating, insecurity, and self-esteem of obese people. They also rated obese patients as less likely than non-obese patients to comply with treatment recommendations.

“I think a better understanding and appreciation of the complexities and difficulties of weight loss are needed to reduce the stigma,” said Rebecca Puhl, the study’s lead author and the director of research and stigma initiatives at Yale University’s Rudd Center for Food Policy and Obesity.

Dr. Nicholas H.E. Mezitis, an assistant professor of clinical medicine and nutrition at Columbia University College of Physicians and Surgeons, disputes the validity of the study, stating that there was too little representation of other ethnic groups outside of white females.

The study recommends adding stigma reduction to the standard curriculum for dietetics programs.

Let me play a little devil’s advocate here. Let’s say for argument’s sake that Dr. Mezitis is wrong and that the study does reveal that dietitians-in-training are representative of society as a whole and have negative views of obese people. Not that it’s a good thing, but will it ultimately significantly hinder their ability to treat and give optimal advice to those people? You’d just have to believe that dietitians wouldn’t take it to the point of openly berating people. That’s not expecting much.

(via: Yahoo News)

March 12th, 2009

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One Response to “Study Suggests Most Dietitians Stereotype The Obese”


Gin Merritt
Mar 12th, 2009
2:11 pm

It does hinder their ability to treat and give advice to fat individuals.

*Within the United States, 34% of fat adults over the age of 20 are labeled as being “obese” (CDC obesity study, 2007), and 28% of men and 45% of women within this demographic report discrimination based on size (Shkolnikova, 2008). The National Association to Advance Fat Acceptance (NAAFA Healthcare, 2008) found 69% of fat women reported size discrimination from doctors, and 52% had reoccurring experiences of bias with physicians. Discrimination within the healthcare community can lead to fat individuals to be “reluctant to seek health care because of weight bias, which prevents early detection and, this, increases the likelihood of medical problems and health care costs” (Schwartz, Chambliss, Brownell, Blair, & Billington, 2002, p. 1033). These are not the only concerns, as victims of size discrimination within healthcare communities may feel oppressed and silenced.

It is not just openly barrating people that is the problem.

*Even in these politically correct times, discrimination is still prevalent. Sowards and Renegar (2004) claim contemporary discrimination is subtle and occurs in different contexts that make it hard to define and recognize. Fat individuals are discriminated within employment, legislation, and education (About NAAFA, 2008). Another area where discrimination is prevalent is in the healthcare community (About NAAFA).

*For the fat community, health discrimination is a common occurrence. Doctors report responding negatively to fat in a similar fashion as to patients with drug and alcohol addictions and mental health issues (NAAFA Healthcare, 2008, ¶ 2). “Lazy, lacking in self-control, non-compliant, unintelligent, weak-willed, and dishonest” are terms doctors use to describe fat patients and add that fat is perceived in terms of “hostility, dishonesty, and poor hygiene” (NAAFA Healthcare, ¶ 3-4). Nurses also report that fat patients “repulse them” to the point where they do not want to care or touch for these patients (NAAFA Healthcare, ¶ 6). Research has found discrimination interwoven into everyday discourse of health care providers, revealing the lack of awareness of discrimination (Johnson et al., 2004).

*A major concern of size discrimination is the access fat patients have to healthcare and information. Harwood and Sparks (2003) argue that the relationship between provider and patient is important not only for support but, also for information. Health care providers define “health” as an individual issue and typically do not consider important environmental aspects, such as the food access and living conditions, in consultations and diagnosis (Campo & Mastin, 2007). This stereotyping can affect the medical treatment of an individual (Harwood & Sparks), as well as their access to healthcare due to the perceptions healthcare providers construct and share of the stereotyped (Busu & Dutta, 2008). There are major concerns for those discriminated and stereotyped against in a medical setting, as many may then be hesitant to seek medical advice in the future (Schwartz et al., 2002).

So you can see the problem, the discrimination is “different”. Much like women in the 1960′s and 1970′s with sexual harrassment and aquantance rape, fat individuals define this discrimination as size discrimination or fat discrimination. It is not only openlying berating people= discrimination, it includes many other aspects such as simple comments or writing a prescription without actually dignosing the problem:

*Rather than having a physical examination, the doctor wrote her a prescription for a strict diet (Becky). Becky states,
Enter the hip specialist; Dr. Jerkhead (not his real name, but it should be). I limped into his office, MRI report and pictures in hand, and waited patiently. Dr. Jerkhead listened to my description of my hip problems, said, “There’s no way it’s popping out of joint, or you’d be in the emergency room all the time.” Then, he looked at the report (not the pictures) and said that there weren’t any issues (although the report clearly said that there was evidence of arthritis and potential bursitis) and that I just had to lose 100 pounds and I’d be fine. When I said that I couldn’t exercise due to the pain, he told me to just go on a strict diet, and I’d see results. He pulled out a prescription pad, wrote, ‘potatoes, rice, sugar, pop… No!’ then handed it to me, and walked out. The whole ‘consultation’ took less than ten minutes, and did not involve any sort of physical examination (other than his judgment of me as an ignorant fat woman). I walked out feeling attacked and worthless, then I got angry. (¶ 2)

This is the type of treatment many fat individuals face when going to the doctor. I highly suggest reading First, Do No Harm, A blog about fat discrimination in the clinic, to help understand this and perhaps start to change your own perceptions of “those people” (as you put it).

Personally, I have experienced it as well. I’m 5’3″ and 154 pounds. I’ve been this height and about this weight since I was 11. I hit puberty very young, 8, and through out my life have had doctors tell me I need to lose weight. Here’s the thing, I run almost everyday, I can’t name the last time I had fast food, I buy as local and organic as I can, but because I am not thin, I am not considered “healthy”. That’s my issue with the medical field and media right now. We are clearly stating that health = thinness. This makes me worry for those folks out there who are genetically thin, eat fast food, smoke, have sedertary lifestyles, but when people, doctors, you, dietians, see them they are labled as healthy.

Every way I tried to get thin did not work and actually made me even more unhealthy. Research has shown that 35% of women on diets develop patholotical issues, and 25% of women on diets go right into disordered eating. I was one of those. I cut the calories down to 1200 a day. I worked out 2 hours a day. I only ate organic, raw, or whatever my trainer told me to do. And you know what? Soon, if I didn’t stay on target, I was throwing up dinners, I was working out 3 hours, I was doing things that were not healthy to my self or body. There is no healthy diet and no diets work.

What does work is loving yourself for who you are. Realizing your differences are what make you cool. And finding exercise that is fun! Eating when you are hungry and stopping when you are full. Throwing the scale away and not putting your self worth in correlation with a number on a scale. What you all need on here is a HAES advocate.

*this is all from a paper of mine: Healing Aspects of Consciousness-raising: A Narrative Analysis of Blogging in the Fat Acceptance Movement– Submitted to NCA for 2009 Conference