Two of five medical students have a bias against obese people and they don't even know it, according to a study by researchers at Wake Forest Baptist Medical Center in Winston-Salem. The study is published online in the Journal of Academic Medicine.
“Because anti-fat stigma is so prevalent and a significant barrier to the treatment of obesity, teaching medical students to recognize and mitigate this bias is crucial to improving the care for the two-thirds of American adults who are now overweight or obese,” said Dr. David Miller, associate professor of internal medicine and lead author of the study.
The three-year study included more than 300 third-year medical students from 2008 through 2011. The students were from 25 states and 12 other countries.
Researchers used a computer program called the Weight Implicit Association Test to measures students’ unconscious preferences for “fat” or “thin” individuals. Students also answered a survey assessing their conscious weight-related preferences.
Overall, 39 percent of medical students had a moderate-to-strong unconscious anti-fat bias as compared to 17 percent who had a moderate-to-strong anti-thin bias. Less than 25 percent of students were aware of their biases.
The study didn't specify which teaching strategies are most effective, but to combat prejudice, doctors have to acknowledge its existence, Miller said.
At Wake Forest, all third-year medical students in the family medicine program must complete the online Weight Implicit Association Test and then participate in an in-class discussion of their experience with bias.
“Bias can affect clinical care and the doctor-patient relationship, and even a patient’s willingness or desire to go see their physician, so it is crucial that we try to deal with any bias during medical school,” Miller said. “Previous research has shown that ... Doctors are more likely to assume that obese individuals won’t follow treatment plans, and they are less likely to respect obese patients than average-weight patients.”
The study was funded by a grant from the National Cancer Institute. Co-authors are Dr. John Spangler, Mara Vitolins, Stephen Davis, Edward Ip, Gail Marion, and Sonia Crandall of Wake Forest.