June Article of the Month: stigmatizing attitudes and misconceptions about obesity among Spanish healthcare professionals

For the first time in Spain, this research examines weight-related stigma and healthcare professionals’ beliefs about the causes of obesity and the most appropriate ways to address it. This form of stigma can negatively affect the quality of healthcare, relationships between professionals and patients, and access to health services for people living with obesity.

The study was conducted through an online survey distributed by Spanish academic and professional associations connected in some way with obesity research. A total of 922 healthcare professionals from different specialties took part.

The results showed that the surveyed professionals held negative attitudes and stereotypes towards people living with obesity. Stigma levels were higher among younger professionals and those with a lower body mass index. In addition, physicians specialising in obesity displayed the lowest levels of stigma, whereas bariatric surgeons showed the highest.

One of the study’s main findings was the close relationship between stigma and beliefs that attribute obesity to individual responsibility. These beliefs are not supported by the latest scientific evidence, which shows that obesity is a complex chronic disease strongly influenced by biological and socio-environmental determinants.Specifically, almost 40% of the professionals believed that overeating was mainly caused by individual factors, such as emotional eating, food addiction or gluttony. Two-thirds believed that obesity could be completely prevented through an individual commitment to a healthy lifestyle, while 60% considered that it could be cured exclusively through lifestyle changes.The research also found that almost 60% of the professionals attributed difficulties in losing weight primarily to a lack of motivation or self-discipline, which they believed led to a sedentary lifestyle and unhealthy eating habits.

Regarding treatment, more than half of the participants considered lifestyle interventions, psychological support or behavioural modification to be the most effective treatments for severe obesity. This view contradicts clinical practice guidelines, which identify bariatric surgery as the recommended option for this type of obesity.

Overall, professionals who attributed both the causes of obesity and its appropriate management to individual responsibility displayed more stigmatising attitudes than those who attributed them to factors outside a person’s control. The authors suggest that this perception may reflect gaps in professionals’ knowledge of the complexity of obesity and of the different evidence-based treatment options available.

The findings highlight the need to develop training programmes for healthcare professionals that present obesity as a complex, multifactorial condition involving biological, genetic, psychological, social, economic and environmental factors. Many of these factors are not under an individual’s direct control.

Attributing the causes of obesity and focusing its treatment exclusively on individual responsibility may encourage blame and contribute to care that is less respectful, less responsive to patients’ needs and, consequently, less effective. It may also undermine trust in the healthcare system among people living with obesity and discourage them from seeking medical assistance when they need it.

The study was conducted by Dr. David Sánchez-Carracedo, el Dr. Albert Fornieles-Deu and Dra. Dimitra Anastasiadou, members of the Eating and Weight-Related Problems Unit de la Universitat Autònoma de Barcelona, together with Dr. Stuart W. Flint, a researcher at the University of Leeds in the United Kingdom.