Impact of Genetic Causal Information on Medical Students’ Clinical Encounters with an Obese Virtual Patient: Health Promotion and Social Stigma

Abstract

Background

Health care providers will increasingly encounter information about the genetics of obesity as genetics research progresses.

Purpose

This study explores whether information about the genetics of obesity reduces medical student stigmatization of obese patients, and how it affects rates of health behavior-related referral.

Methods

One hundred and ten third and fourth year medical students were randomly assigned to read about genetic or behavioral mechanisms of obesity, or a control topic. Students interacted with an obese virtual patient in a virtual clinic and completed a battery of measures.

Results

Rates of most health behavior screening recommendations (weight loss, exercise, and diet consultations) were lower among participants exposed to genetic causal information than control. The genetic causal information group exhibited less negative stereotyping of the patient than control, F(1,105) = 5.00, p = 0.028, but did not differ in anticipated patient adherence, F(1,105) = 3.18, p = 0.077.

Conclusions

Information highlighting genetic contributions to obesity may lead to both positive and negative outcomes. Communication about the genetics of obesity should discuss the multi-factorial and non-deterministic nature of genetic risk.

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Acknowledgments

This research was supported by the Intramural Research Program of the National Human Genome Research Institute, National Institutes of Health. The authors wish to thank Colleen McBride and Alex Cho for their insightful comments on an earlier version of this manuscript, and Lori Bastian, Greg Feero, and Nancy Stevens for their valuable advice. In addition, the authors thank Laura Wagner, Studly Auguste, ShaDonna Jackson, and Shea Lott for their assistance with data collection.

Conflict of Interest Statement

The authors have no conflict of interest to disclose

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Correspondence to Susan Persky PhD..

Appendix

Appendix

Excerpted conclusion from genetic article—material adapted from [49] and [50]:

Common forms of obesity may be viewed as disorders with genetic underpinnings that occur most readily among individuals who are predisposed to energy conservation both in terms of metabolic processes and in terms of behavioral phenotypes. Help will come with identification of the genes that predispose to obesity, and a fuller understanding of their function.

Excerpted conclusion from behavioral article —additional material adapted from [51]:

Common forms of obesity may be viewed as disorders with possible small genetic influence that occur most readily among individuals who are prone to energy-conserving behaviors consisting of preferential seeking of energy-dense foods and sedentary activities. Current trends in weight-for-height measurements indicate that a major cause of the obesity problem lies in dietary and physical activity patterns.

Excerpted conclusion from control article—material adapted from [52] and [53]:

Chronic daily headache is a relatively common condition associated with significant burden of suffering, but we are only just beginning to understand the pathophysiological mechanisms underlying the chronification of primary headaches. As a result, the management of the most common forms of chronic daily headache is currently nonspecific, non evidence-based, and largely unsatisfactory. Some complementary and alternative treatments do offer hope for chronic headache treatment however, it is quite difficult to differentiate hype from hope or hazard in such treatment.

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Persky, S., Eccleston, C.P. Impact of Genetic Causal Information on Medical Students’ Clinical Encounters with an Obese Virtual Patient: Health Promotion and Social Stigma. ann. behav. med. 41, 363–372 (2011). https://doi.org/10.1007/s12160-010-9242-0

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Keywords

  • Obesity
  • Genetics
  • Stigma
  • Provider attitudes
  • Health behavior
  • Virtual reality