Are Medical Students Aware of Their Anti-obesity Bias?

Abstract

Purpose Anti-obesity prejudices affect the quality of care obese individuals receive. The authors sought to determine the prevalence of weight-related biases among medical students and whether they were aware of their biases. Method Between 2008 and 2011, the authors asked all third-year medical students at Wake Forest School of Medicine to complete the Weight Implicit Association Test (IAT), a validated measure of implicit preferences for “fat” or “thin” individuals. Students also answered a semantic differential item assessing their explicit weight-related preferences. The authors determined students’ awareness of their biases by examining the correlation between students’ explicit preferences and their IAT scores. Results Of 354 medical students, 310 (88%) completed valid surveys and consented to participate. Overall, 33% (101/310) self-reported a significant (“moderate” or “strong”) explicit anti-fat bias. No students self-reported a significant explicit anti-thin bias. According to the IAT scores, over half of students had a significant implicit weight bias: 39% (121/310) had an anti-fat bias and 17% (52/310) an anti-thin bias. Two-thirds of students (67%, 81/121) were unaware of their implicit anti-fat bias. Only male gender predicted an explicit anti-fat bias (odds ratio 3.0, 95% confidence interval 1.8 – 5.3). No demographic factors were associated with an implicit anti-fat bias. Students’ explicit and implicit biases were not correlated (Pearson r = 0.03, P = .58). Conclusions Over one-third of medical students had a significant implicit anti-fat bias; few were aware of that bias. Accordingly, medical schools’ obesity curricula should address weight-related biases and their potential impact on care.

Environmental Scan of Weight Bias Exposure in Primary Health Care Training Programs

“…Research investigating the attitudes of medical students found that approximately 40% of students had significant weight bias, and that two thirds of these students were unaware of their bias (Miller et al, 2013). Similar results have been found with students in other health fields including nursing and psychology students (Waller et al, 2012), dietetics students ) and exercise science students (Chambliss et al, 2004).…”

“…Given the pervasiveness of weight bias in North American society (Puhl & Heurer, 2009) and the dramatic increase in the occurrence of weight bias in recent years Puhl et al, 2008), it is not surprising that health professionals and students are not immune to weight bias (e.g., Miller et al, 2013;Sabin, et al, 2012). Although efforts have been made to reduce weight bias in health professionals (e.g., Poustchi et al, 2013;Rukavina et al, 2010), these programs and interventions are short-term efforts and have not yet been integrated systemically into training curricula.…”

“…Researchers have also investigated the occurrence of weight bias among students enrolled in professional health training programs (e.g., Miller et al, 2013;Phelan et al, 2015;. Research investigating the attitudes of medical students found that approximately 40% of students had significant weight bias, and that two thirds of these students were unaware of their bias (Miller et al, 2013).…”

Subtle Discrimination in the Workplace: A Vicious Cycle

“…Although some individual traits may make us more or less aware of our implicit biases, it is important to note that awareness of implicit biases is a necessary but not sufficient condition for behavioral change. Extant research supports the notion that everyone has implicit and automatic stereotypes that may contribute to expressing prejudice in subtle ways (Madera & Hebl, 2012;Miller et al, 2013).…”

Stigma In Persons with Obesity

“…Preclinical medical students are thus good examples of the effects of both implicit (unconscious) and explicit ( conscious) weight bias. Surveys show more than 40 % of medical students have signifi cant implicit weight bias [ 82 ], yet few are aware of their bias [ 83 ]. Unfortunately, the degree of weight stigma does not decrease with accumulating medical education or clinical experience.…”