The Southern Medical Journal (SMJ) is the official, peer-reviewed journal of the Southern Medical Association. It has a multidisciplinary and inter-professional focus that covers a broad range of topics relevant to physicians and other healthcare specialists.

SMJ // Article

Review Article

Efficacy of Methods for Addressing Antifat Bias in Medical Education

Authors: Clare F. Hartman, BS, Katsiaryna Khatskevich, MD, Ashley Mason, MD, Danielle Gulick, PhD

Abstract

Antifat bias is common in US society, and research supports that it is seen frequently in the healthcare setting. In response, medical schools are including interventions to reduce antifat bias and improve patient care. To the authors’ knowledge, there has been no study that focuses solely on educational interventions to address antifat bias aimed at medical students in the United States. This review examined the current state of research, exploring different methods of addressing antifat bias in US medical education to determine which methods were more effective. We did a literature search using PubMed, Web of Science, and Embase. Eight studies met the criteria for inclusion. Of the eight, one assessed current curriculum, one assessed lectures and case simulations, two were centered around engaging in art, two focused on watching video clips, one was a standardized patient encounter, and one used the elaboration likelihood model. All of the studies showed some decrease in bias in the short term in subjects, whether statistically significant or not. Bias was assessed long term in two studies, and consistent follow-up was identified as important for preserving the decrease in bias. We conclude that addressing antifat bias is sufficient to drive change in medical students, independent of method, at least in the short term. The limitations of the study included the short-term nature of the interventions, the small number of studies, and their differing methods of assessing bias. More research is necessary to evaluate the long-term effects of these interventions and other methods of assessing bias. We hope that this can increase the number of schools including education to challenge antifat bias.

This content is limited to qualifying members.

Existing members, please login first

If you have an existing account please login now to access this article or view purchase options.

Purchase only this article ($25)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.

References

1. Puhl RM, Heuer CA. Obesity stigma: important considerations for public health. Am J Public Health 2010;100:1019–1028.
 
2. Andreyeva T, Puhl RM, Brownell KD. Changes in perceived weight discrimination among Americans, 1995–1996 through 2004-2006. Obesity (Silver Spring) 2008;16:1129–1134.
 
3. Fontaine KR, Faith MS, Allison DB, et al. Body weight and health care among women in the general population. Arch Fam Med 1998;7:381–384.
 
4. Phelan SM, Burgess DJ, Yeazel MW, et al. Impact of weight bias and stigma on quality of care and outcomes for patients with obesity. Obes Rev 2015;16:319–326.
 
5. Kyrou I, Randeva HS, Tsigos C, et al. Clinical Problems Caused by Obesity. Endotext [Internet]. South Dartmouth, MA: MDText.com; 2000.
 
6. Phelan SM, Dovidio JF, Puhl RM, et al. Implicit and explicit weight bias in a national sample of 4,732 medical students: the Medical Student CHANGES study. Obesity (Silver Spring) 2014;22:1201–1208.
 
7. Sutin AR, Stephan Y, Terracciano A. Weight discrimination and risk of mortality. Psychol Sci 2015;26:1803–1811.
 
8. Fitterman-Harris HF, Vander Wal JS. Weight bias reduction among first-year medical students: a quasi-randomized, controlled trial. Clin Obes 2021;11:e12479.
 
9. Nestorowicz S, Saks N. Addressing bias toward overweight patients: a training program for first-year medical students. Med Sci Educ 2021;31:1115–1123.
 
10. Geller G, Watkins PA. Addressing medical students’ negative bias toward patients with obesity through ethics education. AMA J Ethics 2018;20:E948–E959.
 
11. Baker TK, Smith GS, Jacobs NN, et al. A deeper look at implicit weight bias in medical students. Adv Health Sci Educ Theory Pract 2017;22:889–900.
 
12. Gayer GG, Weiss J, Clearfield M. Fundamentals for an osteopathic obesity designed study: the effects of education on osteopathic medical students’ attitudes regarding obesity. J Am Osteopath Assoc 2017;117:495–502.
 
13. Matharu K, Shapiro JF, Hammer RR, et al. Reducing obesity prejudice in medical education. Educ Health (Abingdon) 2014;27:231–237.
 
14. Kushner RF, Zeiss DM, Feinglass JM, et al. An obesity educational intervention for medical students addressing weight bias and communication skills using standardized patients. BMC Med Educ 2014;14:53.
 
15. Poustchi Y, Saks NS, Piasecki AK, et al. Brief intervention effective in reducing weight bias in medical students. Fam Med 2013;45:345–348.
 
16. Gonzalez CM, Lypson ML, Sukhera J. Twelve tips for teaching implicit bias recognition and management. Med Teach 2021;43:1368–1373.
 
17. Shah HS, Bohlen J. Implicit bias. In: StatPearls. StatPearls Publishing; 2023. https://www.ncbi.nlm.nih.gov/books/NBK589697/. Accessed December 3, 2024.