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Many Medical Students Unaware of Their Bias Toward Obese Patients: A Study

May 25, 2013 11:09 AM EDT

Medical students face an uphill battle when it comes to eliminating biases against obese individuals, according to a new study conducted by researchers at Wake Forest Baptist Medical Center.

The report, published in the Journal of Academic Medicine, found that two out of five students studying to be doctors have an unconscious bias against those struggling with obesity.

The three-year study included more than 300 third-year medical students at a medical school in the southeastern United States from 2008 through 2011, though the students themselves were geographically diverse, representing at least 25 different states and 12 countries outside the United States.

The researchers used a computer program called the Weight Implicit Association Test (IAT) to measures students’ unconscious preferences for “fat” or “thin” individuals as well as a survey assessing their conscious weight-related preferences.

The authors then compared the students’ IAT results to their stated preferences to determine whether or not the participants were aware of their biases.

Overall, 39 percent of medical students had a moderate-to-strong unconscious anti-fat bias compared to 17 percent who showed a moderate-to-strong anti-thin bias.

Less than 25 percent of students were aware of their biases.

Such preconceived judgments, researchers warn, often influence the quality of care administered.

“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,” Dr. David Miller, associate professor of internal medicine at Wake Forest Baptist and lead author of the study, said in a press release.

Specifically, Miller explained, previous studies have shown that doctors struggle to show respect to obese patients and are more likely to assume they will not follow treatment plans.

For this reason, Miller believes that medical schools should address weight bias as part of a comprehensive obesity curriculum; in fact, the Wake Forest Baptist team has created an online educational module about fat bias and stigmatization, which is available for free at

The study was funded by the National Cancer Institute.

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