The effect of obesity on medical students’ approach to patients with abdominal pain


Because widely held stereotypes characterize obese people as less intelligent, unhappy, lacking in self control and more prone to psychological problems, we tested whether obese appearance alone would affect medical students’ decisions about the diagnosis and management of simulated patients. We videotaped 4 patient simulators presenting each of 4 cases in 2 states: normal and obese (by using padding and bulky clothing). Seventy-two clinical students at 2 medical schools viewed the cases and answered questions about diagnostic tests and management. We found the expected biases toward patients when in their obese form as well as pessimism about patient compliance and success of therapy, but there were no significant differences in tests or treatments ordered except where appropriate for an obese patient (e.g., weight reduction diet). Thus, the appearance of obesity alone biased the students’ impressions of the patients, but did not affect diagnostic test ordering.

This is a preview of subscription content, access via your institution.


  1. 1.

    Price JH, Desmond SM, Krol RA, Snyder FF, O’Connell JK. Family practice physicians’ beliefs, attitudes, and practices regarding obesity. Am J Prev Med. 1987;3:339–45.

    PubMed  CAS  Google Scholar 

  2. 2.

    Blumberg P, Mellis LP. Medical students’ attitudes toward the obese and the morbidly obese. Int J Eat Disord. 1985;4:169–75.

    Article  Google Scholar 

  3. 3.

    Young LM, Powell B. The effects of obesity on the clinical judgments of mental health professionals. J Health Soc Behav. 1985;26:233–46.

    PubMed  Article  CAS  Google Scholar 

  4. 4.

    Talley NJ, Phillips SF, Melton J, Wiltgen C, Zinsmeister AR. A patient questionnaire to identify bowel disease. Ann Intern Med. 1989;111:671–4.

    PubMed  CAS  Google Scholar 

  5. 5.

    Manning AP, Thompson WG, Heaton KW, Morris AF. Towards positive diagnosis of the irritable bowel. Br Med J. 1978:653–4.

  6. 6.

    Starmans R, Muris JW, Fijten GH, Schouten HJ, Pop P, Knottnerus JA. The diagnostic value of scoring models for organic and non-organic gastrointestinal disease, including the irritable-bowel syndrome. Med Decis Making. 1994;14:208–16.

    PubMed  Article  CAS  Google Scholar 

  7. 7.

    Plackett RL, Burman JP. The design of optimum multifactorial experiments. Biometrika. 1946;33:305–25.

    Article  Google Scholar 

  8. 8.

    Osgood C, Suci G, Tannenbaum P. The Measurement of Meaning. Urbana, Ill: The University of Illinois Press; 1957.

    Google Scholar 

  9. 9.

    McGaghie WC, Whitenack DC. A scale for measurement of the problem patient labeling process. J Nerv Mental Dis. 1982;170:598–604.

    CAS  Article  Google Scholar 

  10. 10.

    Breytspraak LM, McGee J, Conger JC, Whatley JL, Moore JT. Sensitizing medical students to impression formation processes in the patient interview. J Med Educ. 1977;52:47–54.

    PubMed  CAS  Google Scholar 

  11. 11.

    Wee CC, McCarthy EP, Davis RB, Phillips RS. Screening for cervical and breast cancer: is obesity an unrecognized barrier to preventive care? Ann Intern Med. 2000;132:697–704.

    PubMed  CAS  Google Scholar 

Download references

Author information



Corresponding author

Correspondence to Robert S. Wigton MD, MS.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Wigton, R.S., McGaghie, W.C. The effect of obesity on medical students’ approach to patients with abdominal pain. J GEN INTERN MED 16, 262–265 (2001).

Download citation


  • Medical Student
  • Obese Patient
  • Irritable Bowel Syndrome
  • General Internal Medicine
  • Padding