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Addressing Bias Toward Overweight Patients: a Training Program for First-Year Medical Students

Abstract

Background

Physicians may have biases toward overweight patients which likely influences clinical judgments and can lead to disparities in patient care. An increasing number of adults are considered overweight/obese, so it is important to address these biases in training future physicians.

Methods

Forty-five first-year medical students participated in art museum programs and physician presentations, or were part of the control group. Four validated measures Beliefs About Obese Persons Scale, Attitudes Toward Obese Persons Scale, Fat Phobia Scale, and the Harvard Implicit Association Test (IAT) and researcher-generated questions, measured levels of bias before and after study activities.

Results

All participants demonstrated decreased bias. ANCOVA analysis did not reveal significant differences between the experimental and control groups. However, prior to the study 75% of participants had “preference for thin individuals.” Forty percent of those participating in study activities indicated a positive change by associating more positive traits with obese body shapes, compared to 29% of the control group. Study activities were rated positively.

Discussion/Conclusion

The art museum was an engaging/relaxing place for reflection on body types and biases. Physicians provided important instruction for normalization/de-stigmatization of patient care. Although there were no significant findings, the study has raised questions for continuing this work. What are most effective ways/times to address weight bias within the medical school curriculum? Could this work extend to other marginalized patient groups? The diversity in art and humanities creates a rich resource for discussing viewpoints and experiences. The small number of participants and the timing/lack of focus in museum sessions are noted as limitations.

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Notes

  1. The World Health Organization has defined “overweight” as a body mass index (BMI) between 25 and < 30 and “obese” as a BMI over 30. For this study, the two terms are used interchangeably.

  2. Examples of art museum and medical school partnerships can be found at www.utdallas.edu/arthistory/medicine/resources/.

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Acknowledgements

The authors would like to thank Donna Gustafson, PhD, and the Rutgers University Zimmerli Art Museum, and Liesel Copeland PhD for assistance in completing this project.

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Correspondence to Norma Saks.

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This study was reviewed and approved as exempt research by the Rutgers University New Brunswick Health Sciences Review Board.

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The authors declare no competing interests.

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Nestorowicz, S., Saks, N. Addressing Bias Toward Overweight Patients: a Training Program for First-Year Medical Students. Med.Sci.Educ. 31, 1115–1123 (2021). https://doi.org/10.1007/s40670-021-01282-2

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Keywords

  • Pre-clinical medical education
  • Art and medicine
  • Bias
  • Empathy
  • Humanities
  • Obesity