Abstract

BackgroundDespite evidence that biological and genetic factors contribute strongly to obesity, many healthcare providers still attribute obesity more to controllable behavioral issues rather than factors outside a person’s control. We evaluated whether medical school students’ beliefs about obesity correlate with ability to effectively counsel patients with obesity.MethodsClerkship-year medical students at NYU School of Medicine completed an Objective Structured Clinical Experience (OSCE) that tests ability to effectively counsel standardized actor-patients with obesity. We surveyed these students to evaluate their beliefs about the causes of obesity and their attitudes towards people with obesity. We analyzed correlations between student beliefs, negative obesity attitudes, and OSCE performance.ResultsThe response rate was 60.7% (n = 71). When asked to rate the importance of individual factors, students rated controllable factors such as unhealthy diet, physical inactivity, and overeating as more important than genetics or biological factors (p < 0.01). Believing obesity is caused by uncontrollable factors was negatively correlated with obesity bias (r = − 0.447; p < 0.0001). Believing that obesity is caused by factors within a person’s control was negatively correlated with counseling skills (r = − 0.235; p < 0.05).ConclusionsAttribution of obesity to external factors correlated with greater ability to counsel patients with obesity, suggesting that educating providers on the biological causes of obesity could help reduce bias and improve provider care.

Highlights

  • Despite evidence that biological and genetic factors contribute strongly to obesity, many healthcare providers still attribute obesity more to controllable behavioral issues rather than factors outside a person’s control

  • Other environmental factors such as increased portion sizes, easy access to calorie dense foods, increased convenience of eating at restaurants, marketing encouraging food consumption, more sedentary life styles encouraged by the prevalence of television/computer/cellphone screens, a more sedentary occupational landscape, poor food policies, lack of access to healthy food products, and even seemingly unrelated stressors such as psychosocial and financial stress can increase the risk of having obesity [11,12,13]

  • We evaluated whether medical students’ beliefs about causes of obesity correlate with negative biases towards people with obesity, and we determined whether these beliefs and biases are associated with students’ ability to communicate with and counsel patients with obesity as assessed in a standardized patient encounter using a behaviorally anchored checklist

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Summary

Introduction

Despite evidence that biological and genetic factors contribute strongly to obesity, many healthcare providers still attribute obesity more to controllable behavioral issues rather than factors outside a person’s control. Most of the general American public believe that obesity is caused by controllable lifestyle factors rather than biological causes or other external factors. Other environmental factors such as increased portion sizes, easy access to calorie dense foods, increased convenience of eating at restaurants, marketing encouraging food consumption, more sedentary life styles encouraged by the prevalence of television/computer/cellphone screens, a more sedentary occupational landscape, poor food policies, lack of access to healthy food products, and even seemingly unrelated stressors such as psychosocial and financial stress can increase the risk of having obesity [11,12,13]. The evidence on the heritability of obesity and the abundance of uncontrollable environmental factors suggests that obesity results primarily from factors outside an individual’s control

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