Addressing Explicit Weight Bias in Medical Students: Contribution of Demographics and Educational Factors

This study assesses explicit weight bias (EWB) among French medical students and its association with demographic factors and educational tools.

A cross-sectional study assessed EWB among 1,635 students from two universities between June and September 2024. The Anti-Fat Attitudes Questionnaire measured three dimensions: dislike, fear of fat, and belief in weight controllability (willpower). Academic and demographic data were collected, with scores adjusted for sex. Two educational tools were evaluated: a podcast addressing weight bias ("Augusta's Oath") and a clinical rotation in the nutrition department.

On a 1 to 9 scale where higher scores indicate stronger weight bias, medical students showed a moderate overall score (2.7 ± 1.1), with low levels of dislike toward individuals with obesity (1.9 ± 1.2), moderate belief in weight controllability (willpower, 3.1 ± 1.9), and high levels of personal fear of gaining weight (4.2 ± 2.1), indicating a persistent presence of EWB. Men exhibited higher EWB than women. Students who listened to the podcast had significantly lower willpower scores than those of non-listeners (2.6 ± 1.5 vs. 3.1 ± 1.7; p < 0.01) and were half as likely to score above 4, i.e., explicitly expressing bias (59/470; 12% vs. 279/1,164; 24%; OR: 0.50, 95% CI: [0.33; 0.74]; p < 0.01). Nutrition rotations were also associated with slightly lower willpower scores (2.8 ± 1.7 vs. 3.0 ± 1.7, p < 0.01). Neither educational exposure was associated with dislike or fear scores.

EWB, especially fear of getting fat and willpower beliefs, is prevalent among French medical students. Educational podcasts show promise in reducing specific biases, offering tools to combat weight stigma in medical education.