(This is a guest post, written by a med school student, who prefers to remain anonymous. –Amp)
At least at my school, I have often felt that fat-hating is explicitly built into the pre-clinical medical curriculum. I have, thus far, only taken pre-clinical classes, so I have no idea whether the attitudes taught in 1st- and 2nd-year persist beyond this point (or even if anything taught in the first two years matters at all!)
Nevertheless, I was rather infuriated about the way fat was approached in our curriculum. At the time, I had not yet heard of fat acceptance or HAES1, and was still firmly in a dieting mindset. Still, I found the difference between how fat was treated compared to how just about anything else was treated quite remarkable. For every other potentially loaded topic, from smoking to mental illness, there was a concerted and explicit emphasis on (1) following an evidence-based approach, and (2) to treating individuals with kindness and empathy. When it comes to teaching about fat, suddenly all that is thrown out the window.
Some representative examples would be cases where a fat man is described, for comic effect, as having difficulty fitting into a waiting room chair. Or where a woman with a BMI of 23 is described as appearing overweight. Or clinical tutors who repeatedly tell us that “calories in = calories out”, and that fat people simply lack willpower. Or lecturers who tell us that 1200 kCal per day is a reasonable weight-loss diet to recommend to patients. Or descriptions of how weight-loss dieting is the most appropriate response to bullying of fat kids. Or students who make comments in class such as “fat people don’t lose weight because they are stupid”. Or numerous alarmist lectures about the “obesity epidemic”. Etc, etc, etc.
My personal favorite, though, had to be the diabetes lecture where we were given a graph showing rates of obesity and rates of type II diabetes in various countries. The rates did not match up; some countries were identified as having soaring obesity and relatively stable diabetes rates, while others had soaring diabetes and relatively stable obesity rates. The conclusion drawn in the lecture was that the data must be wrong, because, after all, we all know that obesity causes diabetes! If it wasn’t so disturbing it would be quite funny – after all, I’m pretty sure I was taught at some point that the scientific method and evidence-based medicine are not _supposed_ to be about discarding data that do not match your pet hypothesis… ;-)
Those are just my personal impressions, and I don’t know how medical students’ attitudes objectively compare to the general population. I would guess that the teaching doesn’t so much make attitudes worse but rather reinforces the anti-fat attitudes that you’d typically find in a group of affluent young people. Of course, that’s not good enough! They should be actively teaching us to treat fat people well as much as they actively teach us to treat members of any other marginalized group well.
- HAES = “Health At Every Size.” [↩]