Letter to the Editor: Tackling Weight Bias from All Sources

| May 1, 2019

by Peter D. Vash, MD, MPH, FTOS

Dr. Vash is the past executive medical director of The Lindora Medical Clinics and an assistant clinical professor of medicine at UCLA Medical Center. He has served as president for the American Society of Bariatric Physicians (ASBP), now known as the Obesity Medicine Association (OMA), and has served on the board for The North American Society for the Study of Obesity (NASSO), now The Obesity Society (TOS). He is the author of two books.

Dear Bariatric Times Editor,

I’d like to comment on the recent coverage on the topic of weight bias in the March 2019 issue of Bariatric Times; the guest editorial by Kyle1 and article titled, “Weight Bias Among Healthcare Providers: We have Met the Enemy and it is Us,” by Davidson and Davis.2 Both addressed how bias among physicians treating the disease of obesity blocks progress against fighting it. I’m a big fan of Bariatric Times and feel that it is an important service for all healthcare professionals who are involved with the care, management, and treatment for individuals with obesity. These articles help open our eyes to the potential discrimination against individuals with overweight by members of the healthcare community; however, I feel our vision must be clear enough to reveal the many other pervasive biases that are exhibited, explicitly and/or implicitly, and perpetuated from sources other than healthcare professionals. Clearly, these inequitable biases need to be corrected and eliminated but so should the obstructive, misguided, and unproductive policies from other sources such as the policies of the politicians who set healthcare policies; the insurance companies’ policies regarding covered benefits and reimbursements; the pharmaceutical companies’ policies regarding the cost of anti-obesity medications; food corporations and their marketing and advertising policies of pushing cheap, readily available, calorie-dense, sugar-laden fast foods, snacks, and soft drinks; and a general public that holds individuals with overweight and obesity in disdain while continuing to believe in magical weight loss gimmicks, yet avoiding their own responsibly for achieving a healthy weight.

These additional sources of biases are where we need to direct our influential pressure and advocacy efforts to help remove the roadblocks that limit and/or prevent providing compassionate, accessible, and cost-effective obesity treatments. It is important to realize biases against individuals with obesity, and the delivery of their care is a prevalent societal as well as a professional issue. Unfortunately, the source of many of these biases come from a deep and often dark fountain of human nature, and this is a difficult flow to shut off.

However, while eliminating a bias takes time and effort, treating clinicians can often make significant and enduring changes to counter obesity biases one patient at a time. Experienced clinicians must teach, show, and convey empathy through their interaction with patients and drive home the message that obesity is a serious disease,3 and, when treated with respect and understanding, these humiliating biases will become less prevalent. Helping one individual lose weight motivates them to regain their dignity and empower them to advocate for their family, friends, community, businesses, organizations, and others (which might include less empathetic healthcare professionals) to change their way of thinking about and their actions toward “fat people,” thus reducing their discriminating and hurtful biases.

Sincerely,

Peter D. Vash, MD, MPH, FTOS

References

  1. Kyle T. How our own biases are blocking progress against obesity. Bariatric Times. 2019;16(3):3.
  2. Davidson P, Davis PR. Weight bias  among healthcare providers: We have met the enemy and it is us. Bariatric Times. 2019;16(3):16–22.
  3. Vash PD. Yes, obesity is a serious disease but it must also be taken seriously. Obesity. 2014;22:1579.

Response from the authors:

We thank Dr. Vash for his thoughtful comments and agree that many factors contribute to the very serious problem of weight bias.

Sincerely,

Ted Kyle, RPh, MBA; Paul Davidson, PhD, and Pamela R. Davis, RN, BSN, CBN, MBA

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