In a recent article, “Obesity bias, medical technology, and the hormonal hypothesis: should we stop demonizing fat people?,” Richard D. deShazo, MD, noted that medical literature is rife with evidence of clinician bias against “obese” patients. We’ve got obesity, we’ve got morbid obesity, and we’ve got double-morbid-disgusting obesity, etc.

As a medical provider who is active and rides a bicycle almost 20 miles per day, I still fall into the category of “obese.” I am one of them.

With that noted, Dr. deShazo and colleagues have written a very interesting article about clinician bias against “obese” patients, suggesting that the standard paradigms about understanding obesity need to be re-examined.

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“There is also evidence to show that the pathophysiology of obesity is more complex than eating too much and moving too little. Widespread obesity is a new phenomenon in the United States and reflects changes in culture, including food, at many levels,” wrote Dr. deShazo in the abstract. “The modern abundance of low-cost, available, palatable, energy-dense processed foods and the ability of these foods to activate central nervous system centers that drive food preference and overeating appear to play an important role in the obesity epidemic.”

Clinician bias against our heavy patients is well-known, even when we as clinicians also fall into the “obese” category. This article challenges clinicians to rethink our approach to weight and to look for ways to remove the burdens of shame and categorization from the many patients who struggle to achieve weight normality.

Jim Anderson, MPAS, PA-C, ATC, DFAAPA, is a physician assistant in Seattle, WA.


  1. deShazo RD et al. Am J. Med. 2014; doi: 10.1016/j.amjmed.2014.11.024.