Overweight People

Doctors seek to end bias against overweight patients

The Association of American Medical Colleges is rolling out new diversity, equity, and inclusion standards aimed at teaching doctors respectful treatment.

May 21, 2022 By Lauren Sausser | KFF Health News

AAMC PREview® = Professional Readiness Exam

The PREview exam is designed to assess examinees' understanding of effective professional behavior most relevant for entering medical students.

"When Melissa Boughton complained to her OB-GYN about dull pelvic pain, the doctor responded by asking about her diet and exercise habits.

The question seemed irrelevant, considering the type of pain she was having, Boughton thought at the time. But it wasn’t unusual coming from this doctor. “Every time I was in there, she’d talk about diet and exercise,”

On this occasion, three years ago, the OB-GYN told Boughton that losing weight would likely resolve the pelvic pain. The physician brought up diet and exercise at least twice more during the appointment. The doctor said she’d order an ultrasound to put Boughton’s mind at ease.

The ultrasound revealed the source of her pain: a 7-centimeter tumor filled with fluid on Boughton’s left ovary.

“I hate that doctor for the way she treated me — like my pain was no big deal,” Boughton said. “She seemed to make a decision about me based off of a very cursory look.

Research has long shown that doctors are less likely to respect patients who are overweight or obese, even as nearly three-quarters of adults in the U.S. now fall into one of those categories.

The Association of American Medical Colleges is trying to tackle the problem in two ways. .

First, it developed a professional readiness exam for aspiring medical school students, called PREview, designed to assess an applicant’s cultural competence, social skills, and listening skills, as well as their ability to think through situations they may encounter in medical school and clinical settings. “We call them softer skills, but they’re really the harder ones to learn,” said Lisa Howley, an educational psychologist and senior director of strategic initiatives at the association. More than a dozen medical schools now recommend or require that applicants submit their PREview test scores with their Medical College Admission Test scores.

Second, the medical college association will roll out new competency standards for existing medical students, residents, and doctors related to diversity, equity, and inclusion in June. Those standards will address racism, implicit bias, and gender equality and will aim to teach doctors how to talk with people who are overweight." Click link below for entire article. 1

Fat bias at the doctor’s office takes a serious toll

Even with health insurance and ample provider availability, fat discrimination by providers can be a barrier to care for overweight people

by Liora Engel-SmithFebruary 2, 2021

"Alyssa McCord would rather not see a doctor at all. The upstate New York native who now lives in Jacksonville with her husband and daughter attributes some of her reluctance to upbringing. Her parents only went to the doctor when absolutely necessary, she said.

The other part of that reluctance, says the 38 year old, is how providers react to her weight.

McCord, who wears size 20 pants, is used to providers making demeaning comments about her body. Often, they’d blame her weight for every ailment — from heavy periods to colds to numbness and tingling in her hands.

In September, McCord had an experience that surprised even her. She’d gone to a family doctor to discuss consistently heavy periods and constant exhaustion. The doctor said her stomach was cramping because she is fat. If she lost weight, he told her, the pain would go away.

The doctor did not order any of the customary tests, such as abdominal ultrasound or blood tests to confirm his assertion. He looked at her and made up his mind, McCord said.

McCord would later learn from another provider that an enlarged uterus caused the cramps and heavy bleeding. Blood loss from the heavy periods made her anemic, accounting for her fatigue.

Nearly every person in a bigger body has their own story of weight-based bias at the doctor’s office. It could be anything: a too-small blood pressure cuff or medical gown, a wince from a triage nurse during a weigh-in, a negative comment from a physician, or as in McCord’s case, blaming every symptom on weight.

It’s impossible to know exactly how pervasive weight bias is in the health care system, especially because it involves provider attitudes, but it’s safe to say that fat discrimination is rather common, said Ya-Ke “Grace” Wu, assistant professor at the UNC Chapel Hill’s school of nursing.

Current estimates are that 19 to 24 percent of obese adults experience some form of discrimination because of their weight, from bullying at home or work to fat discrimination in clinical settings. The rates of weight bias are even higher in women and people with higher body mass index scores.

Alyssa McCord of Jacksonville, and her daughter Mozelle, now 7, pose for a photo after a 5K in 2018. Photo credit: Alyssa McCord.

No matter how the bias is delivered, the message is clear to any person in a big body: Weight isn’t just a number, it’s a moral failing and a cause for shame.

These negative attitudes from providers have far-reaching health implications, Wu said. Some fat people may avoid the doctor altogether, delaying diagnosis of conditions such as diabetes, high blood pressure, or more serious conditions, such as cancer. Sense of shame about body size can also lead to a host of mental illnesses, from depression to anxiety to suicidal thoughts. It’s even correlated with weight gain and binge eating disorder, a condition that involves cycles of compulsive and restrictive eating." Click link below for entire article. 2

1 https://www.nbcnews.com/health/health-news/doctors-move-end-bias-overweight-patients-rcna29680

2 https://www.northcarolinahealthnews.org/2021/02/02/fat-bias-at-the-doctors-office-takes-a-serious-toll/https://www.northcarolinahealthnews.org/2021/02/02/fat-bias-at-the-doctors-office-takes-a-serious-toll/

_____

Pudendal Neuralgia Alliance

contact@pudendalneuralgiaalliance.org

Paid for by founder until 501c3 status granted by IRS