Saturday, April 17, 2010

op-ed on the stigma of being overweight

As Harriet Brown writes, weight stigma can diminish employment opportunities, lead to direct interpersonal discrimination, and impact mental and physical health. Research on doctors' attitudes shows how deep-seated our prejudices are:

More than half of the 620 primary care doctors questioned for one study described obese patients as “awkward, unattractive, ugly, and unlikely to comply with treatment.” (This last is significant, because doctors who think patients won’t follow their instructions treat and prescribe for them differently.)

...and the negative effects this can have on patients:

Even if doctors don’t directly express weight-based judgments, their biases can hurt patients. One recent study shows that the higher a patient’s body mass, the less respect doctors express for that patient. And the less respect a doctor has for a patient, says Dr. Mary Huizinga, the study’s lead author and an assistant professor at Johns Hopkins School of Medicine, the less time the doctor spends with the patient and the less information he or she offers.

Other studies are flipping the assumption that because overweight and obesity are often associated with mental and physical illness, obesity itself causes these illness. In fact, controlled studies show, the stigma attached to weight may be a more significant cause of illness.

Dr. Peter A. Muennig, an assistant professor of health policy at Columbia, says stigma can do more than keep fat people from the doctor: it can actually make them sick. “Stigma and prejudice are intensely stressful,” he explained. “Stress puts the body on full alert, which gets the blood pressure up, the sugar up, everything you need to fight or flee the predator.”

Over time, such chronic stress can lead to high blood pressure, diabetes and other medical ills, many of them (surprise!) associated with obesity. In studies, Dr. Muennig has found that women who say they feel they are too heavy suffer more mental and physical illness than women who say they feel fine about their size — no matter what they weigh. [emphasis added]

Read the full op-ed for more.

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