Weight Bias in Healthcare: Can It Be Prevented?

If your BMI falls in the healthy range, you most likely don’t get too worried about going in for routine checkups. But for those who are considered to have overweight or obesity medically, those appointments on the calendar might come with a lot of apprehension or even dread. Why? Two words — weight bias.

“Weight bias is very common in healthcare,” says endocrinologist and obesity specialist Marcio Griebeler, MD. “It’s an assumption or belief that is negative most of the time, and it’s based on a person’s appearance or excess weight.”

Dr. Griebeler explains that in the past, it was easy for some healthcare providers to connect health conditions to weight. But these days, it’s not that simple.

“People and doctors used to say, ‘Well, you just have to eat less, exercise more and then take care of yourself.’ But now we know that it’s not like that. It’s much more. There is no one-size-fits-all formula. Everyone is different and it’s very important to personalize medical care, especially from a weight management perspective,” says Dr. Griebeler.

How weight bias negatively affects patients

When we hear disparaging comments or feel like we’re being treated differently because of our appearance, it can make us less receptive to a healthcare provider’s treatment plan. And in cases of weight bias, negative experiences can cause patients to avoid doctors and other medical professionals altogether. Dr. Griebeler believes that this issue can end up being very detrimental.

“The problem with weight bias is that it actually causes harm. It does physical and emotional harm because patients will not want to talk about their health, they might not want to take action when a provider makes recommendations or they might not even seek medical care because of their fears. So, we really need to change this perception,” says Dr. Griebeler.

A recent review designed to explore the evidence and experiences of weight bias in primary healthcare revealed that some patients with obesity noticed medical professionals’ tendencies to attribute all of their health issues to their excess weight. These patients also felt like their providers weren’t listening to them. Because of this, they were more reluctant to talk about symptoms they were experiencing or express general concerns about their health.

What should you do if you feel like a healthcare provider has made assumptions based on your weight?

Dr. Griebeler encourages patients to be their own biggest advocates when it comes to their health. If you feel as if you’re not being heard, speak up. Because if you say nothing, your provider won’t know that they need to take a more relatable approach to your care.

“Like with everything in life, you should be very honest. For instance, if I buy something or go to a restaurant and I don’t like it, I will tell the store or restaurant right away. If you go to a provider and you don’t have a good experience, at the end of the visit you can say, ‘Look, I really didn’t like this approach because…’ and then share how the experience made you feel. Sometimes, a provider could be having a bad day or it could be something else. But if you talk to them in a calm and open way, most providers will understand and try to do better. Our ultimate goal should always be to help and make patients as comfortable as possible,” explains Dr. Griebeler.

But not saying anything or refusing to go to a provider is definitely not the way to go. In the long run, it only hurts the relationship — and possibly, your health.

How to work through negative experiences

You’ve had haircuts that you’d like to forget. You’ve been in fender benders, and you’ve had terrible customer service along the way. These negative experiences most likely haven’t stopped you from driving, getting your hair cut or doing most of the things you enjoy. When it comes to negative healthcare experiences, it should be the same. You can’t let them stop you from making your health a priority.

Dr. Griebeler believes we can always learn from bad experiences. He says all past experiences, good or bad, will help us move through life in better and more constructive ways. He suggests going into appointments with new providers with an open mind. Talk to them about any health and wellness goals you have and establish expectations early so everybody is on the same page.

As your provider creates goals, give your input to help ensure that the goals are realistic and manageable. Also, take note of your provider’s communication style. If they listen to you and acknowledge your concerns, you’re on the right track. If they don’t seem to be receptive, you might want to move on.

“Find someone who you feel comfortable with. If you don’t feel comfortable, maybe that person just isn’t the best fit. Connection is very important so you can work as a team — a collaboration between the patient, provider and others involved with your treatment plan. Find someone who will listen to you and have empathy. You don’t want to feel overwhelmed,” says Dr. Griebeler.

Remember, you are not the problem

Dr. Griebeler says that today, more and more providers are committed to working with patients who are considered to have overweight or obesity. Instead of correlating weight with health conditions, he says the medical community has started to take more realistic and relatable approaches to treatment.

“We now have a larger group of providers who are treating obesity in a different way — with a more holistic approach. And that’s the way to go. So, you shouldn’t continue seeing a provider who you don’t feel comfortable with. There’s a point when you have to move on to someone who understands your concerns,” he says.

Dr. Griebeler adds that the biggest takeaway in all of this is not letting yourself feel like you are responsible for interactions that are rooted in weight bias. He says that obesity is a medical condition just like hypertension is. Your provider should work with you to treat it just like anything else.

“We will treat obesity, and we will make those changes slowly. There are going to be times when you’re going to do very well and other times when you won’t. That’s life. We deal with imperfect situations all of the time. So, how can we expect someone to lose weight if they are stressed at home, working multiple jobs and cannot sleep well? It’s a combination of a lot of things and they’re all interconnected. When it comes to treatment plans, collaborations between doctors and patients are great because if we all work together, we can make a huge difference.”