Tuesday, January 4, 2011

Can Fat Prejudice Be Changed?

Weight bias among healthcare professionals is a significant problem ─ but how do you combat it? 

Here are a couple of recent studies that discuss that.  The first is a review of other studies, and the results are not very encouraging.  The second is a bit more encouraging. 

How do you think we can best combat the issue of weight bias/stigma among healthcare professionals?

Daníelsdóttir S, O'Brien KS, Ciao A. Anti-fat prejudice reduction: a review of published studies.  Obes Facts. 2010 Feb;3(1):47-58.   PMID: 20215795

Division of Psychiatry, Landspítali-University Hospital, Reykjavík, Iceland.


Prejudice against those who are perceived as 'fat' or obese (anti-fat prejudice) is rife, increasing, and associated with negative outcomes for those targeted for such treatment.

The present review sought to identify and describe published research on interventions to reduce anti-fat prejudice. A systematic search of relevant databases (e.g. PsychInfo, PubMed, Scopus) found 16 published studies that had sought to reduce anti-fat prejudice.

Most notable was the lack of research on interventions for reducing anti-fat prejudice. Methodological problems that limit the interpretability of results were identified in the majority of studies found. Interventions employing more rigorous experimental designs provided at best mixed evidence for effectiveness.

Although several studies reported changes in beliefs and knowledge about the causes of obesity, reductions in anti-fat prejudice did not typically accompany these changes. Anti-fat prejudice interventions adopting social norm- and social consensus-based approaches appear encouraging but are scarce.

The lack of prejudice reduction following most interventions suggests that psychological mechanisms other than, or additional to, those being manipulated may underpin anti-fat prejudice. New directions for researching anti-fat prejudice are suggested.

Given the strength of antipathy displayed toward those who are perceived as 'fat' or obese, research in this area is urgently required.

O'Brien KS, Puhl RM, Latner JD, Mir AS, Hunter JA. Reducing Anti-Fat Prejudice in Preservice Health Students: A Randomized Trial. Obesity (Silver Spring). 2010 Nov;18(11):2138-44.  PMID: 20395952

School of Psychological Sciences, University of Manchester, Manchester, UK.


Anti-fat sentiment is increasing, is prevalent in health professionals, and has health and social consequences. There is no evidence for effective obesity prejudice reduction techniques in health professionals. The present experiment sought to reduce implicit and explicit anti-fat prejudice in preservice health students.

Health promotion/public health bachelor degree program students (n = 159) were randomized to one of three tutorial conditions. One condition presented an obesity curriculum on the controllable reasons for obesity (i.e., diet/exercise). A prejudice reduction condition presented evidence on the uncontrollable reasons for obesity (i.e., genes/environment); whereas a neutral (control) curriculum focused on alcohol use in young people.

Measures of implicit and explicit anti-fat prejudice, beliefs about obese people, and dieting, were taken at baseline and postintervention. Repeated measures analyses showed decreases in two forms of implicit anti-fat prejudice (decreases of 27 and 12%) in the genes/environment condition relative to other conditions. The diet/exercise condition showed a 27% increase in one measure of implicit anti-fat prejudice. Reductions in explicit anti-fat prejudice were also seen in the genes/environment condition (P = 0.006).

No significant changes in beliefs about obese people or dieting control beliefs were found across conditions.

The present results show that anti-fat prejudice can be reduced or exacerbated depending on the causal information provided about obesity. The present results have implications for the training of health professionals, especially given their widespread negativity toward overweight and obesity.

1 comment:

the fat nutritionist said...

Fascinating. I'm hoping to attend a summit this month on weight bias, where Rebecca Puhl will be speaking. I need to brush up on this research. I can't help but think that, in addition to receiving "causal information about obesity" that indicates fat people should not be blamed for their weight, maybe fatness needs to be normalized as an aesthetic, and to have different class associations attached to it. Health professionals are prejudiced against fat people not just for "health" reasons, but for the same reasons everyone in our culture is: because there is an underlying belief that fatness is yucky, dirty, low-class, stupid, and morally irresponsible. That's a whole ball of wax, aside from physiological causes of fat, that needs to be dealt with in order to really address the substance of weight bias.

I think :)