20 December 2018

Study: Danish Doctors Have Prejudice Against People with Obesity


In Denmark, general practitioners appear to have negative prejudices against people with obesity, new research from the University of Copenhagen shows. The research is based on answers from 240 doctors. At the same time, though, the new research project shows that the doctors do not discriminate in their treatment, and that the problem mainly concerns doctors’ attitude towards this group of patients, the researchers behind the study believe.

Prejudice against people with obesity is a well-known and widespread problem all over the world. Now, a new research project conducted at the University of Copenhagen shows that these prejudice are also found among Danish general practitioners.

In the project, general practitioners both reveal open and hidden prejudice against people with obesity compared to persons of normal weight.

‘We were not surprised to find prejudice among Danish doctors, because we have seen similar findings in studies conducted by health professionals in the US. But of course, the fact that the prejudice exist indicates that doctors and other health professionals may have to work on their attitude towards large fellow citizens. There was a time when we all believed that people suffering from mental illness and alcoholism “just had to pull themselves together”. We may have to undergo a similar change in attitude with regard to overweight’, says co-author of the study, Professor Peter Sandøe from the Department of Veterinary and Animal Sciences and the Department of Food and Resource Economics.

Hypothetical Headache
The study is based on a questionnaire answered by a total of 240 general practitioners, corresponding to 14 per cent of those invited to participate. Male and ageing doctors were slightly over-represented compared to the general composition of doctors in Denmark. But seeing as this is the first study of its kind in a Danish context, it does nevertheless give us an important indication, the researchers find. 

It appeared from a so-called implicit bias test, the objective of which was to identify hidden prejudice, that the doctors more easily associate persons with obesity with words signalling laziness and lack of motivation than with words signalling the opposite characteristics.

In addition, the doctors were asked more direct questions about their attitude towards overweight patients. Together these questions were meant to reveal prejudice against overweight persons among Danish doctors.

Furthermore, part of the questionnaire was meant to uncover whether the doctors would treat overweight persons differently than persons of normal weight. Each doctor was presented with one out of four possible patient scenarios which they had to consider. They could be given a person with obesity or a person of normal weight, and the patient could either be a man or a woman.

The questionnaire also included a photo of the patient in question and a description of headache symptoms, which were the same in all four scenarios. Subsequently, the doctors had to answer a series of questions on how they would treat the patient in the hypothetical scenario.

No Differential Treatment Despite Prejudice

’The prejudice are rather significant. In general, the doctors are less sympathetic towards people with overweight and to a greater extent consider them lazy compared to people of normal weight. But it is also important to say that fortunately we found no evidence of differential treatment or discrimination in the way the doctors would treat them. Thus, their personal opinion does not appear to affect their professional decisions’, says first author of the scientific article, Associate Professor Thomas Bøker Lund from the Department of Food and Resource Economics.

In the study, the doctors showed a much greater tendency to advice persons with obesity to undergo a general health check than persons of normal weight. So here the researchers do detect a difference in the way the two weight groups are treated. According to the researchers, though, this difference may be strictly by the book.

‘Medically, it makes a lot of sense to offer persons with overweight and not persons of normal weight a health check, as the risk of developing cardiovascular diseases and diabetes is much higher in the former group, and doing so may be seen as a sign of compassion on the part of the doctors’, says co-author of the study, Professor of General Medicine John Brodersen from the Department of Public Health.

Most doctors advised the patients to keep a journal on their headache symptoms and to consider consulting a doctor at a later point. One group of patients stood out, though.

 ’A significantly lower number of doctors advised men with obesity to follow up with a new consultation or a journal compared to men of normal weight. And we actually found a connection to the doctors’ own overall life style: The healthier their self-reported life style, the lower the probability of doctors advising men with obesity to follow up with one of the two options. A possible explanation could be that the doctors’ own self-control in the form of a healthy life style is related to their view of the self-control of overweight men. We have no documentation for this, though, but it provides us with material for further research’, says Peter Sandøe.

Occasional headache symptoms were chosen because there is no documented relation between headache and overweight, which could explain differences in the way the doctors chose to treat the patients.

Read the entire study: ‘A Study of Anti-Fat Bias among Danish General Practitioners and Whether This Bias and General Practitioners’ Lifestyle Can Affect Treatment of Tension Headache in Patients with Obesity. Lund, Brodersen, and Sandøe. Obesity Facts 2018


Associate Professor Thomas Bøker Lund
+45 35 33 68 61

Professor Peter Sandøe
+45 21 49 72 92

Professor John Brodersen
+45 20 27 61 81

Press Officer Mathias Traczyk
+45 93 56 58 35