What Doctors Can Do About Weight Bias in Health Care

As you know if you've read recent posts, I've talked about weight bias (AKA "size prejudice") in health care before. For example, Size Prejudice Is Alive and Well, Part 2 is about how prevalent weight bias is among doctors and other health care professionals. What I didn't talk about was what doctors could do about it...probably because I didn't know.

Well this week I discovered this video, which was created by the Yale Rudd Center for Food Policy and Obesity. It lists many things that doctors--and other health care professionals--can do to reduce weight bias in their own practices and thereby improve their patients' care and quality of life. (P.S. I plan to write more about the Rudd Center very soon.) If you're in a hurry, fast forward to 9:14 for the actual action items.

Have you experienced weight bias in a health care setting? Do you know any health care professionals that might benefit from seeing this video? Share your story in the comments.

The Last 'Acceptable' Prejudice

So it turns out patients aren't the only ones that some doctors are willing to treat as "less than" due to weight. (Reference Size Prejudice is Alive and Well, Part 2.) Who else do they turn their prejudice on? Each other.

Source: philly.com

Joseph Majdan, MD, FACP, is Assistant Professor Clinician Educator and Director, Professional Development at Jefferson University Hospitals in Philadelphia, PA. He was, by his own admission, obese for most of his life, including during his medical training. After he lost a large amount of weight and kept it off for almost a year, he wrote an essay for the Annals of Internal Medicine on the cruel treatment he received at the hands of fellow students and even teachers.

Read Dr. Majdan's essay here.

The heaviness of my heart when I heard what he endured could hardly be overstated. The levels of cruelty and unprofessionalism are beyond mind boggling.

Dr. Majdan, who in a philly.com article calls obesity "the last . . . prejudice openly accepted by society," "just kept quiet [in the past] when doctors said things he found hurtful. He admired doctors so much that he took their criticism to heart." But "[h]e plans to speak up now. 'Sometimes we have to teach other people how to treat us,' he said. 'From now on, I call them on it.'"

Also, according to the article, as part of his role as director of professional development, he works with medical students who are having interpersonal problems. One hopes that through that work he is instilling greater sensitivity in the next generation of medical professionals.

Via YouTube, Young Girls Ask if They're Pretty

YouTube still used by huffingtonpost.com

This breaks my heart so much, I can barely write about it. Fortunately, the Huffington Post already has. So has jezebel.com. And SFGate.

According to these articles, it's a growing trend: Many pre-teen and teen girls (and a few boys), some as young as 11, have posted videos of themselves on YouTube, asking people whether they're pretty (or ugly).

I could only bring myself to watch one, in which the girl, after pointing out her koala hat (unwittingly demonstrating her still-little-girl-ness), says:

I just wanted to make a random video, seeing if I was, like, ugly or not? Because a lot of people call me ugly, and I think...I'm ugly and fat. But all of my friends and girls, they're just like, "Oh, you're so beautiful, oh you're so beautiful. I just wish I was you 'cause you're so beautiful." I'm just like, [adamantly] "Shut up, 'cause I'm not beautiful." And I was just going to show you pictures of me. Well, I think they're...pretty nice...uh, if that, I'm like, pretty or not.

Let me be clear about something: She is neither. Ugly nor fat.

Clearly, her self-image, while not good, is in conflict. That's natural; she's a pre-teen. But asking a world wide web of strangers to "tell" her whether she's beautiful? Not at all where she should be getting her self-image from. And why doesn't she know that?

I haven't even told you any of the comments yet. I can't bring myself to read most of them. Suffice it to say that while some people are affirming, many are not. You know the drill: people can be cruel, people can be sick, and the Internet allows a measure of anonymity, so the sick-cruel find an excuse to say what they might not otherwise.

As SFGate put it, "YouTube is the last place these kids should be going to for a confidence boost; the site is bound to make them only feel worse. A 12-year-old isn’t mature enough to deal with vicious remarks made by their mean-spirited peers and sick-minded Internet trolls.... Adolescence is dark and savage and when teenagers put themselves up on the Internet it only magnifies the experience."

YouTube, in its Terms, says, "...you affirm that you are over the age of 13, as the Service is not intended for children under 13. If you are under 13 years of age, then please do not use the Service. There are lots of other great web sites for you. Talk to your parents about what sites are appropriate for you." Newsflash, YouTube: No one reads Terms!

If you're wondering, "Where are the parents?"...yeah, so am I. What I hate the most about that is: "where are the parents" has almost become a cliché.

Maybe part of why this breaks my heart is: I don't remember being told I was beautiful by anyone at home, and I was told the opposite by my peers. I was teased cruelly and called names related to my appearance. I can still remember some of those incidents. I was convinced I was unattractive and that boys would not like me. In other words: I was once that girl. I know how much damage a ruined body image can wreak.

Only in my mid-to-late-30s and early 40s did I begin to truly believe that I was attractive. That means that for the majority of my first 40 years, I walked around consciously believing that I was un-lovely. Is it any wonder why I've struggled to relate in the world, why I've (with one grand exception) struck out with men?

Well I guess I was able to write more about this than I thought. But all I can say in closing is: Wow, are our priorities ever screwed up.