I am biased.

We all judge others on their appearance. It’s just inescapable, and physicians are definitely susceptible. It shapes the way we interact with coworkers as well as patients, all the way down to the micro-messages we send: facial expressions, eye contact, interruptions, little harmless scoffs…

Implicit bias seems to come naturally. Much of it is functional and helps us get through our daily lives, especially our clinical shifts. It’s the basis for heuristic decision making, and we really do need it! But there is a fine line, and it can quickly become harmful.

When we think about implicit bias, racism and sexism enter our minds first. These absolutely need to be addressed, but there are countless other types too. Think also about those who suffer discrimination on the basis of disability, age, sexual orientation, and – yes – even body weight.

Research shows that patients with obesity perceive interactions with physicians more negatively,1 but there are also professional implications. In the general population, overweight women earn almost $19,000/year less than their average-weight peers.2 And among physicians, 87% have implicit weight bias against their own colleagues.3

I have experienced the effects of obesity bias personally. And although it still feels a little uneasy to share with the whole world, I’m excited and even relieved to be finally telling my story in this FIX19 talk. Obesity bias exists and is harmful, and most of us contribute to the problem without realizing it. Case in point: even though I have struggled with obesity personally, I still have implicit obesity bias.

So, what can we do about our own biases? Whether it’s obesity bias or any other type, the first and most important step is simply awareness of our own implicit biases. Everyone is susceptible, and you’ll never know unless you do some real soul searching to find out. Try taking the Implicit Association Test, and you might be surprised. I certainly was!


  1. Richard P, Ferguson C, Lara A, Leonard J, Younis M. Disparities in Physician-Patient Communication by Obesity Status. Inquiry 2014;51:1-7. PMID: 25432989
  2. Judge TA, Cable DM. When it comes to pay, do the thin win? The effect of weight on pay for men and women. J Appl Psychol. 2011;96(1):95‐112. doi:10.1037/a0020860. PMID: 20853946
  3. McLean ME, McLean LE, MS, McLean-Holden AC, Campbell L, Horner AM, Kulkarni M, Melville L, Fernandez EA. (2020). Collegial Physician Weight Bias: A Cross-Sectional Observational Survey Study to Guide Implicit Bias Training in the Medical Workplace. Manuscript in preparation.

Watch the FIX19 talk below!