Medical Student Weight Bias: the Relationship of Attitudinal Constructs Related to Weight Management Counseling
- 95 Downloads
Obesity is a prevalent disease that is often a source of stigmatization. Weight bias has been documented in healthcare settings and associated with less physician time spent with patients, less patient-centered communication, and more patient delay or withdrawal from care. Weight bias is widespread in society and the healthcare field, including among medical students. This study examined the hypothesis that weight bias in medical students is related to negative attitudes toward weight management counseling (WMC), perceived WMC skills, and self-efficacy for WMC. A sample of 762 medical students during their core clerkship rotation (graduating class of 2017) from eight US medical schools completed questions related to weight bias, attitudes toward WMC, perceived WMC skills, and self-efficacy for WMC. Results indicated that medical students with more weight bias held more negative attitudes toward WMC, even after adjustment for age, gender, and intended medical specialty. Weight bias was not significantly related to perceived WMC skills or self-efficacy for WMC. Females had a more positive attitude toward WMC, but lower perceived WMC skills and self-efficacy for WMC than males. Males had significantly more weight bias and were less likely to choose primary care than females. Implications for medical education are discussed.
KeywordsWeight bias Weight management counseling Medical students Medical education
The MSWeight program is supported by a grant from NCI. The authors thank the MSWeight investigators and staff, the participating medical schools and students, and the weight bias consultant for their dedication and making this study possible. We acknowledge all school site PIs, research coordinators, evaluators, research assistants, support staff, and the participating medical students and course directors who have implemented and participated in the study thus far.
Research reported in this publication was supported by the National Cancer Institutes of Health under Award 5R01CA194787. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
- 1.Ogden CL, Carroll MD, Fryar CD, Flegal KM. Prevalence of obesity among adults and youth: United States, 2011–2014. NCHS Data Brief. 2015;219:1–8.Google Scholar
- 5.Washington RL. Childhood obesity: issues of weight bias. Prev Chronic Dis. 2011;8(5):A94.Google Scholar
- 12.Khandalavala BN, Rojanala A, Geske JA, Koran-Scholl JB, Guck TP. Obesity bias in primary care providers. Fam Med. 2014;46(7):532–5.Google Scholar
- 19.Andrade AD, Ruiz JG, Mintzer MJ, Cifuentes P, Anam R, Diem J, et al. Medical students’ attitudes toward obese patient avatars of different skin color. Stud Health Technol Inform. 2012;173:23–9.Google Scholar
- 21.Association of American Medical Colleges. The prevention and treatment of overweight and obesity. In Report VIII, Contemporary Issues in Medicine, Medical School Objectives Project. USA: Association of American Medical Colleges; 2007.Google Scholar
- 23.Wiese HJ, Wilson JF, Jones RA, Neises M. Obesity stigma reduction in medical students. Int J Obes Relat Metab Disord. 1992;16(11):859–68.Google Scholar
- 24.Poustchi Y, Saks NS, Piasecki AK, Hahn KA, Ferrante JM. Brief intervention effective in reducing weight bias in medical students. Fam Med. 2013;45(5):345–8.Google Scholar
- 27.Roberts DH, Kane EM, Jones DB, Almeida JM, Bell SK, Weinstein AR, et al. Teaching medical students about obesity: a pilot program to address an unmet need through longitudinal relationships with bariatric surgery patients. Surg Innov. 2011;18(2):176–83. https://doi.org/10.1177/1553350611399298.CrossRefGoogle Scholar
- 29.Ockene JK, Ashe KM, Hayes RB, Churchill LC, Crawford SL, Geller AC, et al. Design and rationale of the medical students learning weight management counseling skills (MSWeight) group randomized control trial. Contemp Clin Trials. 2018;64:58–66. https://doi.org/10.1016/j.cct.2017.11.006.CrossRefGoogle Scholar
- 31.Jensen MD, Ryan DH, Apovian CM, Ard JD, Comuzzie AG, Donato KA, et al. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Obesity Society. J Am Coll Cardiol. 2014;63(25 Pt B):2985–3023.CrossRefGoogle Scholar
- 32.Fitzmaurice GM, Laird NM, Ware JH. Applied longitudinal analysis. New York: Wiley; 2004.Google Scholar
- 34.Molenberghs G, Verbeke G. Models for discrete longitudinal data. New York: Springer Science and Business Media, Inc; 2005.Google Scholar
- 35.Smith S, Seeholzer EL, Gullett H, Jackson B, Antognoli E, Krejci SA, et al. Primary care residents’ knowledge, attitudes, self-efficacy, and perceived professional norms regarding obesity, nutrition, and physical activity. J Grad Med Educ. 2015;7(3):388–94. https://doi.org/10.4300/JGME-D-14-00710.1.CrossRefGoogle Scholar