Weight bias and social work practice: An empirical exploration

There is ample evidence in the non-social work literature to suggest that weight bias by health and mental healthcare professionals is a serious social problem with very negative potential psychological, social, and medical consequences for obese clients. Despite the important role of social work practitioners in challenging various types of bias and discrimination, the topic of possible weight bias by social work professionals has been wholly neglected in the weight bias research literature to date. The purpose of the current study is to assess weight bias among social work clinicians and to determine its potential impact on social work practice. The study is based on a survey sample of 564 social workers who are members of the National Association of Social Workers. Respondents were mailed a self-administered questionnaire which included pre-existing measures of attitudes toward obese people, beliefs about controllability, and original measures of social work practice behaviors with obese clients, their own experience with obesity, and questions regarding the perceived importance of weight bias to social work practice. Significant relationships were found between beliefs about controllability of obesity and negative attitudes toward obese people, as well as among beliefs about controllability, attitudes toward obese people and social work practice behaviors. Specifically, respondents who believed more strongly that obesity is under an individual's control tended to have more negative attitudes toward obese people overall. Further, those respondents with more negative attitudes toward obese people, demonstrated more negative practice behaviors in work with obese or significantly overweight clients. Respondents with higher Body Mass Indexes, with a family history of obesity, with more friends who are obese, and with higher percentages of obese clients in practice, demonstrated more positive attitudes toward obese people. Likewise, younger social workers demonstrated significantly more tolerance toward obese persons. Weight bias among female respondents was influenced by different variables than that of male respondents. Perception of the importance of weight bias to individual practice of respondents significantly differed from the perceived importance of weight bias to their clients, suggesting that level of value placed on weight bias may be an important factor in understanding social work's neglect of this issue to date. Overall, these findings suggest that weight bias does exist among social workers and it can negatively impact practice with obese clients. Implications for policy and future research are considered.