Faculty of Medicine, University of Zurich, Zurich, Switzerland.
Department of Surgery and Transplantation, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Obes Facts. 2023;16(4):381-391. doi: 10.1159/000530405. Epub 2023 Mar 28.
Weight bias refers to negative attitudes toward individuals because of their weight. Evidence-based strategies to successfully reduce weight bias in medical students are lacking. The purpose of this study was to investigate the impact of a multifaceted intervention on medical students' attitudes toward patients with obesity.
Third and fourth year medical students (n = 79), who enrolled in an 8-week graduate course focusing on the various epidemiologic, physiological, and clinical aspects of obesity, including a gamification task with bariatric weight suits (BWSs), were asked to complete the Nutrition, Exercise and Weight Management (NEW) Attitudes Scale questionnaire pre- and post-course. The inclusion period was between September 2018 and June 2021 and covered 4 consecutive groups of students.
The overall NEW Attitudes Scale scores did not change significantly pre- versus post-intervention (pre-course: 19.59, post-course: 24.21, p value = 0.24). However, the subgroup of 4th year medical students showed a significant improvement in their attitudes (pre-course: 16.4, post-course: 26.16, p value = 0.02). The Thurstone rating of 9 out of 31 individual survey items changed significantly from pre- to post-course with a moderate strength (Cramer's V >0.2), including 5 items showing weight bias reduction. The disagreement with the statement "overweight/obese individuals lack willpower" increased from 37 to 68%.
These findings suggest that in medical students with a low level of weight bias at baseline, a semester course on obesity combined with BWS use affects only a limited number of items of the NEW Attitudes Scale questionnaire. The sensitization of medical students to weight stigma has the potential to improve quality of healthcare for patients with obesity.
体重偏见是指由于个体的体重而对其产生的负面态度。目前缺乏有效的策略来成功减少医学生的体重偏见。本研究旨在探讨一种多方面干预措施对医学生对肥胖患者态度的影响。
第三和第四年的医学生(n=79)参加了一个为期 8 周的研究生课程,该课程侧重于肥胖的各种流行病学、生理学和临床方面,包括一个使用减重服(BWS)的游戏化任务,学生在课程前后被要求完成营养、运动和体重管理(NEW)态度量表问卷。纳入期为 2018 年 9 月至 2021 年 6 月,涵盖了 4 个连续的学生组。
NEW 态度量表的总分在干预前后没有显著变化(课前:19.59,课后:24.21,p 值=0.24)。然而,四年级医学生的态度有显著改善(课前:16.4,课后:26.16,p 值=0.02)。31 个单项调查项目中的 9 个项目的 Thurostone 评分从课前到课后有显著变化,具有中度强度(Cramer's V >0.2),包括 5 个显示体重偏见减少的项目。对“超重/肥胖个体缺乏意志力”这一说法的反对率从 37%增加到 68%。
这些发现表明,在基线体重偏见水平较低的医学生中,肥胖学期课程结合 BWS 使用,仅对 NEW 态度量表问卷的有限数量的项目产生影响。医学生对体重耻辱感的敏感性有可能改善肥胖患者的医疗保健质量。