Effects of medical trainees' weight-loss history on perceptions of patients with obesity

Abstract

Context: Medical professionals often express weight-biased attitudes. Prior research suggests that people who overcome a challenge are critical of individuals who struggle to overcome the same challenge. Thus, medical trainees who have successfully achieved and maintained weight loss may express greater weight bias and more critical attitudes toward patients with obesity who fail to overcome these challenges.

Objectives: This study was designed to determine the effects of medical trainees' weight-loss history on weight-biased attitudes and responses to patients with varying weight-loss outcomes.

Methods: An online survey was completed by 219 medical students and internal medicine residents. Participants' weight-biased attitudes were assessed before they were randomly assigned to read one of three patient vignettes in which the patient lost no weight, lost/regained weight, or lost/maintained weight. Independent measures included trainee gender, trainee weight loss and maintenance, and the three experimental conditions of patient outcomes. Dependent measures included the Anti-Fat Attitudes (AFA) Questionnaire's Willpower and Dislike subscales, ratings (on a scale of 1-7) of compassion, frustration, and blame toward the patients presented in the vignettes, and perceptions of the physician-patient alliance. All analyses controlled for trainee body mass index.

Results: Among trainees, 67.1% reported having successfully lost weight. Of those who had lost weight, 79.5% reported maintaining their weight loss. Trainees who had successfully lost/maintained weight expressed less compassion toward patients across vignettes (5.4 ± 1.2 versus 5.9 ± 1.2; p<0.05), and more blame toward the patient who lost/regained weight than did trainees who had lost/regained weight (3.4 ± 1.3 versus 2.3 ± 1.3; p<0.01). Overall, the patient who did not lose weight was viewed most negatively, followed by the patient who lost/regained (all p-values < 0.05). Female (but not male) trainees who had successfully lost weight expressed stronger weight-biased attitudes on the AFA scales than did those who had never lost weight (all p-values < 0.01).

Conclusions: Medical trainees' personal success with weight loss and maintenance may negatively affect their perceptions of patients with obesity who struggle with weight management.