An alarming two out of five medical students are unconsciously biased against obese patients, according to a study by Wake Forest Baptist Medical Center in Winston-Salem, North Carolina. The study was published in the Journal of Academic Medicine.
David Miller, M.D., associate professor of internal medicine at Wake Forest Baptist, along with colleagues, conducted the study as part of the medical school鈥檚 curriculum on obesity. Their goal: Measuring unconscious weight-related biases among medical students.
The study took place over a three-year period from 2008 to 2011 and included more than 300 third-year students at a medical school in the southeastern U.S. Students came from all parts of the nation and world, representing 25 different states and 12 foreign countries.
Dr. Miller said in a Wake Forest Baptist that future doctors must become more sensitive to patients with weight problems.
鈥淏ias can affect clinical care and the doctor-patient relationship, and even a patient鈥檚 willingness or desire to go see their physician, so it is crucial that we try to deal with any bias during medical school,鈥� Dr. Miller said.
Dr. Miller said that previous research shows that, on average, like the general public, physicians have a strong 鈥渁nti-fat鈥� bias. 鈥淒octors are more likely to assume that obese individuals won鈥檛 follow treatment plans, and they are less likely to respect obese patients than average weight patients,鈥� he said.
A computer program, the Weight Implicit Association Test (IAT), was used to measure students鈥� preferences for 鈥渇at鈥� or 鈥渢hin鈥� people. In addition, students answered a survey about their conscious weight-oriented preferences. Researchers determined if students knew about biases by checking if IAT results matched stated preferences.
The percentages were eye-opening: 39% of medical students 鈥渉ad a moderate to strong unconscious anti-fat bias as compared to 17% who had a moderate to strong anti-thin bias.鈥� Fewer than 25% of students studied were even aware of their biases.
Dr. Miller said medical education can help combat the problem: 鈥淏ecause 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...Medical schools should address weight bias as part of a comprehensive obesity curriculum.鈥�
Effective teaching strategies were not included in the study, but Dr. Miller believes acknowledging the existence of obesity bias among medical students is of paramount importance. Wake Forest Baptist requires all third-year medical students in its family-medicine clerkship to complete the online IAT and also participate in a discussion about their experience with the bias. Dr. Miller points out that students must face the fact that their bias 鈥渃ould affect their actions and adopt new strategies to mitigate bias.鈥�
Wake Forest Baptist has an online educational module, funded by the National Cancer Institute, for medical students everywhere about fat bias and the stigma involved at
(Top photo) Photo: Yves Picq/Wikimedia Commons
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