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The Association of American Medical Colleges is rolling out new diversity, equity, and inclusion standards aimed at teaching doctors respectful treatment.

In 2013, the American Medical Association voted to recognize obesity as a disease. “We call them softer skills, but they’re really the harder ones to learn,” said Lisa Howley, an educational psychologist and senior director of strategic initiatives at the association. That doctor referred Boughton to a surgical oncologist, who removed the tumor, her left ovary, and part of a fallopian tube. Boughton sought a second opinion from a doctor who marketed her practice as a “Healthy at Every Size” office. The way parents and providers talk to kids about their weight can have lifelong consequences and in some cases trigger unhealthy eating habits. That’s not happening for many patients, said Dr. Scott Butsch, director of obesity medicine at the Cleveland Clinic’s Bariatric and Metabolic Institute. “This is almost like malpractice. “I hate that doctor for the way she treated me — like my pain was no big deal,” Boughton said. Some obesity experts blame a lack of focus on the subject in medical schools. Research has long shown that doctors are less likely to respect patients who are overweight or obese, even as nearly three-quarters of adults in the U.S. now fall into one of those categories. “Every time I was in there, she’d talk about diet and exercise,” said Boughton, who is 34 and lives in Durham, North Carolina. The question seemed irrelevant, considering the type of pain she was having, Boughton thought at the time. The physician brought up diet and exercise at least twice more during the appointment.