COMMENTARY

An Unmet Need in Medical Training: Addressing Weight Bias

Rebecca M. Puhl, PhD

Disclosures

February 03, 2014

In This Article

Strategies to Reduce Weight Bias in Medical Training

To this end, research evidence suggests that several strategies may be key in efforts to address weight bias in medical training. First, we know from experimental research that educating students about the complex etiology of obesity can help challenge common perceptions that obesity is the result of laziness or low willpower, which often lead to blame and bias toward individuals with obesity. Studies testing this approach have presented students with information about obesity, including biological and genetic factors, and the challenges of achieving significant long-term weight loss.[15,16,17] This strategy has both reduced negative weight biases in students and increased their confidence in counseling patients with obesity. Furthermore, this strategy has shown to be effective in a variety of training formats, including lectures, reading materials, brief films, and simulated training with virtual patients, thus providing a range of settings in which such training could be feasibly implemented.

Second, we need to better train medical students on how to talk about weight-related health with their patients. Such training needs to include ways for trainees to start productive and positive conversations about weight with patients, and education about what language to use to describe weight and how their language is perceived by patients. Teaching students clinical approaches such as motivational interviewing can also be very helpful in their efforts to engage in proactive and supportive communication to elicit health behavior change in their patients.

Third, we cannot ignore students' perceptions, frustrations, and pessimism pertaining to the provision of treatment to patients with obesity. With so little content on obesity or nutrition in medical school curricula, there is significant room for improvement to educate students about evidence-based approaches for obesity treatment, management, and intervention. This needs to include recognition of the challenges and complexities of weight control, realistic expectations for weight loss, and increased focus on how to encourage and support patients to improve their nutrition and physical activity regardless of their body weight.

In summary, the research evidence and its implications are clear: Pervasive weight biases among medical students necessitate intervention to reduce such bias and its impact on patient care. Efforts to increase education and awareness of weight bias and its consequences are warranted, both in medical training and among practicing healthcare providers and medical educators, whose attitudes can have a powerful influence on students training in professional health disciplines. These efforts will be necessary to help shift otherwise socially acceptable and harmful attitudes toward patients with obesity in the clinical care setting.

For educational resources on weight bias in the healthcare setting, including videos, toolkits, informational handouts, and continuing medical education, please visit the Rudd Center Website.

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