CoChat
Sign Up
Cited by 439Obesity and Health PracticesSocial and Intergroup PsychologyObesity, Physical Activity, Diet

Implicit and Explicit Anti-Fat Bias among a Large Sample of Medical Doctors by BMI, Race/Ethnicity and Gender

Open access
Sabin, Janice A., Marini, Maddalena, Nosek, Brian A.·2012·PLoS ONE
DOI 10.1371/journal.pone.0048448PMC PMC3492331
Open this paper in CoChat — free accountOpen PDF

Abstract

Overweight patients report weight discrimination in health care settings and subsequent avoidance of routine preventive health care. The purpose of this study was to examine implicit and explicit attitudes about weight among a large group of medical doctors (MDs) to determine the pervasiveness of negative attitudes about weight among MDs. Test-takers voluntarily accessed a public Web site, known as Project Implicit®, and opted to complete the Weight Implicit Association Test (IAT) (N = 359,261). A sub-sample identified their highest level of education as MD (N = 2,284). Among the MDs, 55% were female, 78% reported their race as white, and 62% had a normal range BMI. This large sample of test-takers showed strong implicit anti-fat bias (Cohen's d = 1.0). MDs, on average, also showed strong implicit anti-fat bias (Cohen's d = 0.93). All test-takers and the MD sub-sample reported a strong preference for thin people rather than fat people or a strong explicit anti-fat bias. We conclude that strong implicit and explicit anti-fat bias is as pervasive among MDs as it is among the general public. An important area for future research is to investigate the association between providers' implicit and explicit attitudes about weight, patient reports of weight discrimination in health care, and quality of care delivered to overweight patients.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1371/journal.pone.0048448

Cites

5 of 5 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 37

  1. [1]Kim J, Peterson KE, Scanlon KS, Fitzmaurice GM, Must A, et al (2006) Trends in overweight from 1980 through 2001 among preschool-aged children enrolled in a health mainteinance organization. Obesity 14: 1107– 1112. 16899790
  2. [2]Flores G (2010) Technical Report-Racial and Ethnic Disparities in the Health and Health Care of Children. Pediatrics 125: e979– e1020. 20351000
  3. [3]van Gerwin M, Franc C, Rosman S, Le Vallant M, Pelletier-Fleury N (2008) Primary care physicians' knowledge, attitudes, beliefs and practices regarding childhood obesity: A systematic review. Obesity Reviews: 1–10. 19021874
  4. [4]Jay M, Kalet A, Ark T, McMacken M, Messito MJ, et al (2009) Physicians' attitudes about obesity and their associations with competency and specialty:A cross-sectional study. BMC Health Services Research 106: 1– 11. PMC2705355 19552823
  5. [5]Foster GB, Wadden TA, Makris AP, Davidson D, Sanderson RS, et al (2003) Primary care physicians' attitudes about obesity and its treatment. Obesity Research 11: 1168– 1177. 14569041
  6. [6]Warner CH, Warner CM, Morganson J, Appenzeller GN, Rachal J, et al (2008) Military family physician attitudes toward treating obesity. Military Medicine 173: 978– 984. 19160616
  7. [7]Andreyeva T, Puhl RM, Brownell KD (2008) Changes in perceived weight discrimination among Americans, 1995–1996 through 2004–2006. Obesity (Silver Spring) 16: 1129– 1134. 18356847
  8. [8]Anderson DA, Wadden TA (2004) Bariatric surgery patients' views of their physicians' weight-related attitudes and practices. Obes Res 12: 1587– 1595. 15536222
  9. [9]Puhl RM, Brownell KD (2006) Confronting and coping with weight stigma: an investigation of overweight and obese adults. Obesity (Silver Spring) 14: 1802– 1815. 17062811
  10. [10]Wee CC, McCarthy EP, Davis RB, Phillips RS (2000) Screening for cervical and breast cancer: is obesity an unrecognized barrier to preventive care? Ann Intern Med 132: 697– 704. 10787362
  11. [11]Mitchell RS, Padwal RS, Chuck AW, Klarenbach SW (2008) Cancer screening among the overweight and obese in Canada. Am J Prev Med 35: 127– 132. 18617081
  12. [12]Dovidio J, Gaertner SL (2000) Aversive Racism and Selection Decisions: 1989 and 1999. Psychological Science 11: 315– 319. 11273391
  13. [13]Greenwald AG, Poehlman AT, Ulhman E, Banaji MR (2009) Understanding and using the Implicit Association Test: III. Meta-analysis of predictive validity. Journal of Personality and Social Psychology 97: 17– 41. 19586237
  14. [14]Puhl RM, Heuer CA (2010) Obesity stigma: important considerations for public health. Am J Public Health 100: 1019– 1028. 20075322 PMC2866597
  15. [15]Teachman BA, Brownell KD (2001) Implicit anti-fat bias among health professionals: Is anyone immune? International Journal of Obesity 25: 1525– 1531. 11673776
  16. [16]Schwartz MB, Chambliss HO, Brownell KD, Blair SN, Billington C (2003) Weight bias among health professionals specializing in obesity. Obesity Research 11: 1033– 1039. 12972672
  17. [17]Nosek BA, Smyth FL, Hansen JJ, Devos T, Lindner N, et al (2007) Pervasiveness and variability of implicit attitudes and stereotypes. European Review of Social Psychology 18: 36– 88.
  18. [18]Greenwald AG, McGhee DE, Schwartz JL (1998) Measuring individual differences in implicit cognition: The Implicit Association Test. Journal of Personality and Social Psychology 74: 1464– 1480. 9654756
  19. [19]Nosek BA, Greenwald AG, Banaji MR (2007) The Implicit Association Test at age 7: A methodological and conceptual review; In: Bargh JA, editor: Psychology Press.
  20. [20]Hofmann W, Gawronski B, Gschwender T, Le H, Schmitt M (2005) A meta-analysis on the correlation between the Implicit Association Test and Explicit self-report measures. Personality and Social Psychology Bulletin 31: 1369– 1385. 16143669
  21. [22]Elgoff B, Schwerdtfeger A, Schmukle SC (2005) Temporal stability of the Implicit Association Test- anxiety. Journal of Personality Assessment 84: 82– 88. 15639771
  22. [23]Sabin J, Nosek BA, Greenwald A, Rivara FP (2009) Physicians' implicit and explicit attitudes about race by MD race, ethnicity, and gender. J Health Care Poor Underserved 20: 896– 913. 19648715 PMC3320738
  23. [25]Cooper LA, Roter DL, Carson KA, Beach MC, Sabin JA, et al (2012) The associations of clinicians' implicit attitudes about race with medical visit communication and patient ratings of interpersonal care. Am J Public Health 102: 979– 987. 22420787 PMC3483913
  24. [27]Greenwald AG, Nosek BA, Banaji MR (2003) Understanding and using the Implicit Association Test I: An improved scoring algorithm. Journal of Personality and Social Psychology 85: 197– 216. 12916565
  25. [28]Cohen J (1988) Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Lawrence Earlbaum Associates.
  26. [30]Nosek BA, Smyth FL, Hansen JJ, Devos T, Lindner N, et al. (2007) Pervasiveness and variability of implicit attitudes and stereotypes. European Review of Social Psychology: 36–88.
  27. [31]Penner LA, Dovidio JF, West TV, Gaertner SL, Albrech TL (2010) Aversive racism and medical interactions with black patients: A field study. Journal of Experimental Psychology 46: 436– 440. PMC2835170 20228874
  28. [32]Rhodes SD, Bowie DA, Hergenrather KC (2003) Collecting behavioural data using the world wide web: considerations for researchers. J Epidemiol Community Health 57: 68– 73. 12490652 PMC1732282
  29. [33]Nosek BA, Banaji MR, Greenwald AG (2002) eResearch: Ethics, security,design, and control in psychological research on the Internet. Journal of Social Issues 58: 161– 176.
  30. [34]Davis RN (1999) Web-based administration of a personality questionnaire: Comparison with traditional methods. Behav Res Methods Instrum Comput 31: 572– 577. 10633976
  31. [35]Skitka LJ, Sargis EG (2006) The internet as psychological laboratory. Annn Rev Psychol 57: 529– 555. 16318606
  32. [36]Nosek BA, Greenwald AG, Banaji MR (2005) Understanding and using the Implicit Association Test: II. Method variables and construct validity. Pers Soc Psychol Bull 31: 166– 180. 15619590
  33. [37]Kraut R, Olson J, Banaji M, Bruckman A, Cohen J, et al (2004) Psychological research online: Report of board of scientific affairs' advisory group on the conduct of research on the Internet American Psychologist. 59: 105– 117. 14992637
  34. [38]Cronk BC, West JL (2003) Personality research on the Internet: A comparison of web-based and traditional instruments in take-home and in-class settings. Behav Res Methods Instrum Comput 34: 1770180. 12109009
  35. [39]Greenwald AG, Nosek BA, Banaji MR (2003) Understanding and using the implicit association test: I. An improved scoring algorithm. J Pers Soc Psychol 85: 197– 216. 12916565
  36. [40]Story M, Stevens J, Himes JH, Stone E, Rock BH, et al (2003) Obesity in American-Indian children: prevalence, consequences, and prevention. Prevention Medicine 37: S3– 12. 14636804
  37. [41]Davis NJ, Shishodia H, Taqui B, Dumfeh C, Wyle-Rosett J (2007) Resident physician attitudes and competence about obesity treatment: Need for improved education. Med Educ Online 13. PMC2779605 20165535

Cited by

Sorted by citations

Authors
Sabin, J. A., Marini, M., & Nosek, B. A.
Affiliations
  • University of Washington (US)
  • University of Modena and Reggio Emilia (IT)
  • University of Virginia (US)
Corresponding author
Sabin, Janice A.
ORCID
Venue
PLoS ONE
Publisher
Public Library of Science (PLoS)
Published
2012-11-07
Volume
7
Issue
11
Pages
e48448
ISSN
1932-6203 (ISSN-L)
DOI
10.1371/journal.pone.0048448
PMC
PMC3492331
OpenAlex
W2047208004
Cited by
439
References
5
Citations by year
2026: 24 · 2025: 36 · 2024: 45 · 2023: 49 · 2022: 33 · 2021: 39 · 2020: 27 · 2019: 30 · 2018: 34 · 2017: 26 · 2016: 36 · 2015: 24 · 2014: 15 · 2013: 19 · 2012: 1
FWCI
44.14
Type
journal article
Language
en
Open access
Licence
Locations
  • PLoS ONE (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Archivio Istituzionale della Ricerca - Università degli Studi della Campania "Luigi Vanvitelli" (submittedVersion)
Topics
  • Health Sciences › Health Professions › Pharmacy › Obesity and Health Practices
  • Social Sciences › Sociology and Political Science › Social and Intergroup Psychology
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Keywords
anti-fat bias, implicit bias, explicit attitudes, physicians, weight discrimination, overweight patients, body mass index, Project Implicit, quality of care, race and ethnicity, gender
MeSH terms
Adult, Attitude of Health Personnel, Body Weight, Female, Humans, Male, Physicians, Prejudice, Sex Characteristics, Body Mass Index, Racial Groups

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review