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Implicit anti-fat bias among health professionals: is anyone immune?


OBJECTIVE: To investigate whether negative implicit attitudes and beliefs toward overweight persons exist among health professionals who specialize in obesity treatment, and to compare these findings to the implicit anti-fat bias evident in the general population.

DESIGN: Health care professionals completed a series of implicit and explicit attitude and belief measures. Results were compared to measures obtained from a general population sample.

SUBJECTS: A total of 84 health professionals who treat obesity (71% male, mean age 48 y, mean body mass index (BMI) 25.39).

MEASUREMENTS: Participants completed an attitude- and a belief-based lmplicit Association Test. This reaction time measure of automatic memory-based associations asked participants to classify words into the following target category pair. ‘fat people’ vs ‘thin people’. Simultaneously, the tasks required categorization of words into one of the following descriptor category pairs: good vs bad (attitude measure) or motivated vs lazy (stereotype measure). Participants also reported explicit attitudes and beliefs about fat and thin persons.

RESULTS: Clear evidence for implicit anti-fat bias was found for both the attitude and stereotype measures. As expected, this bias was strong but was lower than bias in the general population. Also as predicted, only minimal evidence for an explicit anti-fat bias was found. Implicit and explicit measures of the lazy stereotype were positively related although the attitude measures were not.

CONCLUSION: Even health care specialists have strong negative associations toward obese persons, indicating the pervasiveness of the stigma toward obesity. Notwithstanding, there appears to be a buffering factor, perhaps related to their experience in caring for obese patients, which reduces the bias.

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We are grateful to the Rudd Foundation for their support of this work, as well as Knoll Pharmaceutical Company for allowing us to collect data during their physicians' conference. In addition, the authors wish to thank Mahzarin Banaji, Subathra Jeyaram, Brian Nosek and members of the Yale Center for Eating and Weight Disorders research team for their assistance on this project and helpful comments in preparation of this manuscript.

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Correspondence to KD Brownell.



Sample portion of an IAT task measuring implicit associations among fat and thin people with lazy and motivated descriptors. This page would be compatible for people who have implicit anti-fat bias, since the pairings match negative automatic associations with overweight. The opposite pairing (fat people with motivated and thin people with lazy) would be incompatible or a mismatch for people who have implicit anti-fat bias.Table A1

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Teachman, B., Brownell, K. Implicit anti-fat bias among health professionals: is anyone immune?. Int J Obes 25, 1525–1531 (2001).

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  • implicit attitudes
  • bias
  • anti-fat
  • obesity

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