Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Med Educ. 2017 Aug;51(8):802-811. doi: 10.1111/medu.13275. Epub 2017 May 11.
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.
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.
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.
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).
Medical trainees' personal success with weight loss and maintenance may negatively affect their perceptions of patients with obesity who struggle with weight management.
医学专业人士经常表现出对体重的偏见态度。先前的研究表明，克服挑战的人会对那些努力克服同样挑战的人持批评态度。因此，成功减肥并保持体重的医学生可能会对未能克服这些挑战的肥胖患者表现出更大的体重偏见和更批评的态度。
本研究旨在确定医学实习生的减肥史对体重偏见态度以及对体重减轻结果不同的患者的反应的影响。
通过在线调查，219 名医学生和内科住院医师完成了一项调查。参与者在随机分配阅读三个患者病例中的一个之前，评估了他们的体重偏见态度，其中患者体重未减轻、减轻/增加体重或减轻/保持体重。独立措施包括学员性别、学员减肥和维持情况以及患者结局的三个实验条件。因变量包括反胖态度问卷的意志力和不喜欢分量表、对病例中呈现的患者的同情、沮丧和责备评分（评分范围为 1-7），以及对医患联盟的看法。所有分析均控制了学员的体重指数。
在学员中，67.1%报告成功减肥。在那些减肥的人中，79.5%报告维持体重减轻。成功减肥并保持体重的学员在所有病例中对患者的同情心较低（5.4±1.2 与 5.9±1.2；p<0.05），并且对减轻/增加体重的患者的责备感高于减轻/增加体重的学员（3.4±1.3 与 2.3±1.3；p<0.01）。总体而言，未减轻体重的患者受到的评价最差，其次是减轻/增加体重的患者（所有 p 值均<0.05）。与从未减肥的学员相比，成功减肥的女性（而非男性）学员在 AFA 量表上表现出更强的体重偏见态度（所有 p 值均<0.01）。
医学实习生成功减肥和保持体重可能会对他们对肥胖患者的看法产生负面影响，这些患者在体重管理方面存在困难。
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