Nurses biased against obese patients?

A recent article in the LA Times, “Doctors and nurses’ weight biases harm overweight patients,” takes nurses to task for their collective prejudice against obese people. “At least 11 studies focusing on nurses’ attitudes toward overweight and obese patients have been published,” the article said. “They consistently show that many nurses harbor negative biases toward these patients and, in some cases, would prefer not to care for them or even touch them.”

According to the research studies, most nurses perceive obese people as lazy and unmotivated, and obesity as a failure of will. But nurses are obese too. A 2008 study published in the Journal of the American Academy of Nurse Practitioners found that 53% of nurse-respondents surveyed were obese. The national obesity rate for Americans, according to the National Center for Health Statistics, is 64%.

Local studies occasionally reveal even higher rates of nurse obesity. An NYU student surveyed 66 nurses on a Cardiac Intensive Care Unit in a major hospital in New York. Eighty-six percent of the nurses were obese, despite “having appropriate educational materials at their fingertips for the prevention and treatment of obesity.”

Yet studies consistently reveal a pronounced anti-fat bias among nurses — and education does not seem to be the answer. In fact, a 2009 study published in the Journal of Clinical Nursing, found that Registered Nurses held more negative attitudes toward obese patients than student nurses did.

What do you think? Do you think nurses are biased against overweight patients? Have you seen examples of anti-fat prejudice at work?


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Jennifer Fink, RN, BSN

Jennifer is a professional freelance writer with over eight years experience as a hospital nurse. She has clinical experience in adult health, including med-surg, geriatrics and transplant; she also has a particular interest in women’s health and cancer care. Jennifer has written a variety of health and parenting articles for national publications.

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28 Responses to Nurses biased against obese patients?

  1. Lyn

    YES I am biased against fat people! I hate the fact that I have to turn them with the help of five other nurses. I am disgusted when I have to spoon-feed them because their arms are so fat that they can’t get a fork to their mouths. And it takes an army to clean them when they defecate in their beds! I think we have good reason for our bias.

  2. tanya

    That is the ugliest thing I have ever heard! I hope you are a nurse because u wanted to help people……how can u be so mean?????

  3. Dani

    It’s hard not to become biased when the majority of fat patients seem not to care about becoming healthier, are totally noncompliant and don’t put any effort into trying to lose weight. Then we nurses risk injuring ourselves trying to move them. One bad lift and we’re not able to work because we have a bad back, and we can’t provide for our families anymore. We may care about the person, but it’s difficult not to feel a little resentful when their bulk is such an obstacle and a hazard. Couldn’t they at least try to stick to their diet plans instead of having friends and family sneak in candy bars and such?

    • cartiepie

      I agree, Dani. My back is shot now and I can’t work. But I don’t blame the fat people. I blame the administration for forcing (usually) not very strong women to move these heavyweights around without the tools to move them. The construction industry gets hydraulics, cranes, etc., when they have to move heavy stuff. That’s what we need.

  4. Dawn

    Wow Lyn, and just why are you a nurse? Do you feel the same way about a patient with COPD on 4 liters of O2 but yet still smokes? What about the woman that comes into the hospital, 40 weeks gestation, stung out on crack? While it may certainly take some extra effort from time to time to provide an obese person cares, it takes time to provide cares to any patient!

  5. Jeffrey Bodurka

    I have worked with more than my fair share of obese patients. That said, I could care less what a patients weight is. Sure it may mean getting called to assist the aid more often and in many cases there is more time spent just on assessment, treatment and in the end education but when I walk into a patients room I treat everyone the same regardless. Having a bias against anyone for any reason is detrimental to patient care and if you exhibit an attitude such as Lyn’s (spoon feeding is spoon feeding regardless of why your doing it) maybe you need to look up the word empathy and reconsider just why your in the patients room in the first place.

  6. Your name

    Maybe it is simply the arm pain and back pain and how hindered I am in taking care of my own family following a couple shifts with the obese pt. I don’t think nurses are prejudice, I think we are in pain!!!

  7. Your name

    Maybe it is simply the arm pain and back pain and how hindered I am in taking care of my own family following a couple shifts with the obese pt. I don’t think nurses are prejudice, I think we are in pain!!!

  8. Erica

    I know nurses and doctors who are obese.There are over 300 genes which influence obesity.While you still need to eat too much and make poor food choices to become morbidly obese genetics do make it hard. Once overweight your body works less efficiently at burning calories so less food causes weight gain and so on. Care for all patients compassionately or change your career.

  9. Their being obese isn’t entirely their fault. Obesity, in many people, can be traced back to their childhood. And it’s gotten them into that deep pit already before they even know what it means to be obese. And while nurses may not see their efforts of losing weight, they should well know how hard it is to actually say no to food, much like how they thoroughly understand that drug addicts find it hard to run from drugs that they even need expert’s help.

  10. Amy

    Am I little prejudice against the plumper people? Well yes I am! As was said by someone else in this blog, these patients often consume staffing resources – i.e. 4 staff members required to give any kind hygiene or repositioning. In addition to the exponentially greater surface area that needs to be cleaned and the exponentially greater number of creases that need to be de-crusted, de-pooped and anti-fungalled or that require dressings because the skin is literally anaerobically consuming itself.

    I am prejudice because I’ve had numerous arguments with numerous obese patients over the necessity to remove their foley caths – disgusted that they would rather risk a raging UTI than have to walk to the bathroom.

    Prejudice aside, I care for my patients no matter what their size, shape, color, or walk of life. Any prejudice I have I keep in my head and don’t allow it to interfere with the quality of care I deliver. A nurse has gotta be allowed an inner dialect!!

  11. Janice

    My feelings are mixed. I hate the pain of turning, cleaning up, holding a urinal for a man who can’t reach “it”; however, I was an obese nurse. After gastric bypass surgery, I weight 170 lbs. less. Sooo, when I have an obese patient I try to use it as an opportunity to teach. Some are receptive, some are not. If I can help just one, it is worth the pain.

  12. get real

    I am overweight, and a nurse. There is a difference between being overweight, and being so morbidly obese that people can’t do their job to help you without literally putting their own safety and health at risk.
    I definitely have a bias against morbidly obese patients, just as a I have a bias against people who refuse to quit smoking or who can’t stop drinking excessively or using drugs. There are numerous groups of patients that we, as nurses, are biased against because of the physical and emotional strain that they place on us and the risk that they pose to our own safety and well-being. Does this bias mean that I treat them with any less respect or compassion than I treat my other patients? Absolutely not. But it does exist and we would be lying if we said that it didn’t

  13. Angie

    I am bias about obese pts, as well as COPDers who still smoke, crack heads giving birth and walking away for someone else to clean up their mess. BUT, I never have and never will allow that to affect my compassion for my pt.
    I’ll never forget about 2 cases while in nursing school. One pt was SO obese she could not get the proper test done because she exceeded, not only the weight limit for the MRI but also the “roundness” also. I aided in helping 5 other nurses and student nurses to put a foley cath in this pt. It took 2 people per leg, one person to “spread the lips and folds” and the charge still took 5 minutes before getting the cath in. That’s ridculous.
    The other case was a pregnant drug head who lost her baby at 8 months d/t her drug use. It was documented over and over to her that death could happen to her unborn child, but she continued. Two day later she was arrested for murder and sent to prison. I feel bad for her because when she sobered up I know she felt ashamed but….you know what….its called a choice people…..we make them everyday and live with our mistakes.

  14. kate

    Nobody on here said that they provide less care to those who are obese or outwardly treat them differently. Unless you are in the position of a nurse having to deal with these people and the extra burden and risks they place on you, don’t judge the thoughts of nurses. You have no idea what it is like, and it becomes all the more difficult when it is completely unnecessary.

    • dreilin

      Well Kate. It’s ironic that you feel, “judged.” The interesting thing is that I am super morbidly obese AND an RN so that means I CAN judge you. My thought, filtered anyways, is that you are an idiot. Don’t think for ONE minute that being obese is completely controllable unless you are willing to discard half of your brain…oh wait, seems like you are willing to do that. God help us all people – the level of inhumanity on here is infuriating. Half of you suck really bad as human beings.

  15. Kate

    If i hear about how people “became nurses to help people” one more time I am going to scream! Yes, helping people is a good addition benefit to the career choice, but that is not the main reason for many people. To be a nurse involves both science, knowledge, instinct, and skill. Many choice nursing for the continuing challenge and scientific interest the career entails. To say that a nurse is simply a nurse because they ‘want to care for people’ is totally undermining the intelligence and skill it takes to actually be a nurse.

    • melissarb1999

      Really? I hope you get paid enough for that Scientific Skill and knowlegde, much less instinct. I do not know too many nurses that have worked in a variety of health care settings that ,”Do it for “The Scientific Skills””. Yes, nursing is a profession, a profession that holds everyone in it accountable and at a higher standard as models to our patients and society as a whole. We teach, care, listen, counsel,advocate, and a host of other “Humanistic” features. There is no room in this career choice to prejudice anything a patient does or has done to put their health in jepordy. If nursing to people hasnt changed the prejudice you feel toward certain things and people in general, you do have a “Job”.

  16. bobbi

    this is sick. that is bad

  17. Nina

    Obesity should be looked at like any other disease process. Diabetics crave sugar,,, heart patients crave salt. Once the obesity has occured the fat cells scream for food. Most of these comments are spoken like someone who has never had a weight problem. If you are burned out get out. Go be a school nurse, get in the business end of the game, got to a clinic or something. The greatest thing about being a nurse is there are so many choices to choose from.

  18. rak

    when i was working for a short while in a nursing home there was a resident who required 5 aides just for repositioning. I was given this resident to care for the day i finished orientation. it seems that cnas also “eat their young” i ended that shift horribly upset that i was unable to provide proper care because she was too heavy.

  19. amrqrs

    If you hate working with certain patients, perhaps you should go back to school and work in medical research so that you can avoid working with people. One of the reasons many obese people often avoid medical care until they are seriously ill is because of the way they are treated when they seek medical care. I am a teacher, and if I found myself hating special education students because of the extra resources and time that they require (and believe me, the trainably mentally handicapped require all that you have described here, with the exception of surgical care), I would then know it was time to find a new profession. I might be “teaching” all of my students, but if I hate some of them, I have no business working with them. Teaching is a calling. Nursing is a calling. We don’t do this kind of work for the pay. If you don’t have the compassion for other human beings to help you to see beyond the needs that bring them to you, you need to find a new career.

  20. Belasko

    I did go into nursing to help people, I still enjoy that aspect of my job. I also enjoy the science and the rationals behind why we do things. But I also have some biases about the obese pt’s, the drug addicts, the COPD pt’s that smoke, and the diabetic that drinks a 12 pack of regular pepsi every day. I call it natural selection. Every one of those people have the option to get help. They may need some directing to find the resources, but they are out there. Fact is most of them blow us off when we offer. In the end though I don’t let my thoughts direct my care for my pt’s. They get the same care as anyone else. I do questions the actual numbers of truly obese nurses though. Based on our hospital health screening this year I’m borderline obese and I have a 34″ waist. BSI isn’t always the most accurate assessment tool they make it out to be.

  21. cartiepie

    I worked with some VERY heavy people, up to 500 or 600 pounds. But I don’t blame the obese people. I blame the administration for making (mostly) women heft these people around without the lifting tools they need to prevent themselves from getting hurt. Heck, the construction industry (mostly men) get hydraulic lifters, cranes, many tools to lift those weights that are actually more than a human should try to lift. We don’t. Why? Because administration takes advantage of nurses’ desire to help people, even if the patient is heavier than we can lift without hurting ourselves. The administration is making money off of our altruism.