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Even Dieticians May Have Negative Attitudes Toward the Obese


New Haven, Conn. — In a study that gives insight into the depth of stigmatization against overweight and obese people, a Yale University-led team of researchers found weight bias even among those studying to be dieticians. The research appears in the March issue of the Journal of the American Dietetic Association.

This comes on the heels of another study published by the same researchers in the January 2009 issue of the journal Obesity that found stigmatization of obese adults is rampant among employers, educators, health care providers, family members and romantic partners.

The latest study represents the first experimental research to examine weight bias among dietetic professionals. Researchers investigated the attitudes of 182 dietetic students toward obese patients. Dieticians are especially important to examine, said the researchers, due to the frequency of their interactions with overweight and/or obese patients and the considerable time they spend counseling people struggling with their weight.

According to the results, attitudes of weight bias and fat phobia based solely on patient body mass index (BMI) were common among students. Negative stereotypes included beliefs that obese individuals are lazy, lacking in willpower, insecure and less likely to comply with treatment compared to thinner patients.

“These stereotypes are similar to negative attitudes reported by a range of health-care providers,” write authors Rebecca Puhl and Chelsea Heuer of the Rudd Center for Food Policy and Obesity at Yale and Christopher Wharton of Arizona State University. “Our findings are worrisome because the quality of patient care can be compromised by negative provider attitudes and bias. There is a clear need to address this issue in training of health care professionals.

Specific findings of this research include:

* More than 40 percent of students reported that they believe obese individuals are lazy, lacking in willpower, and are self-indulgent.
* The majority of students surveyed also agreed that obese individuals have poor self-control, overeat, are insecure and have low self-esteem.
* Students rated obese patients as being significantly less likely to comply with treatment recommendations and as having worse diet quality and health status compared to thinner patients, despite the fact that all patients were described as healthy adults.
* Only two percent of students demonstrated positive or neutral attitudes toward obese individuals.

“Unfortunately, the growing science on this topic demonstrates that weight bias persists and has expanded to other domains previously unstudied,” wrote authors Puhl and Heuer in the Obesity article. “Without sufficient attention to this issue, it is likely that weight bias will remain both a social injustice and a public health issue, impairing the quality of life for present and future generations of obese individuals.”

About the Rudd Center for Food Policy and Obesity at Yale University
The mission of the Rudd Center is to improve the world’s diet, prevent obesity, and reduce weight stigma through creative connections between science and public policy, targeted research, frank dialogue among key constituents, and a commitment to real change. The Rudd Center assesses, critiques, and strives to improve practices and policies related to nutrition and obesity so as to inform and empower the public, promote objective, science-based approaches to policy, and maximize the impact on public health. For more information, please visit:

Multimedia Resources Available
Yale University’s Rudd Center has created two new educational videos that demonstrate the problems associated weight bias at home, in schools and within healthcare settings, to help increase public awareness about the issue of weight stigmatization. The videos, which use expert commentary and dramatic representation to address the obstacles obese individuals encounter with weight bias in American society, are hosted by celebrity and activist Emme, and feature Rudd Center experts including Dr. Puhl, Dr. Kelly Brownell and Dr. Marlene Schwartz. The videos are available for free download at


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