Explicit Weight Bias Research Articles

Weight-based disparities in perinatal care: quantitative findings of respect, autonomy, mistreatment, and body mass index in a national Canadian survey

BackgroundQualitative studies document episodes of weight-related disrespectful care, particularly for people with high body mass index (BMI ≥ 30) and reveal implicit and explicit biases in health care providers. No large quantitative studies document the pervasiveness of weight stigma or if experiences change with increasing BMI.MethodsThe multi-stakeholder RESPCCT study team designed and distributed a cross-sectional survey on the experiences of perinatal services in all provinces and territories in Canada. From July 2020 to August 2021, participants who had a pregnancy within ten years responded to closed and open-ended questions. Chi square analysis assessed differences in mean scores derived from three patient-reported experience measures of autonomy (MADM), respect (MOR), and mistreatment (MIST). Controlling for socio-demographic factors, multivariate logistic regression analysis explored relationships between different BMI categories and respectful care.ResultsOf 4,815 Canadians who participated, 3,280 with a BMI of ≥ 18.5 completed all the questions. Pre-pregnancy BMI was significantly associated with race/ethnicity, income sufficiency, and education but not with age. Individuals with higher BMIs were more likely to experience income insufficiency, have lower levels of education, and more frequently self-identified as Indigenous or White. Those with BMI ≥ 35 exhibited notably higher odds of reduced autonomy (MADM) scores, with an unadjusted odds ratio of 1.62 and an adjusted odds ratio of 1.45 compared to individuals with a normal weight. Individuals with BMIs of 25–25.9, 30–34.9, and ≥ 35 exhibited odds of falling into the lower tercile of respect (MOR) scores of 1.34, 1.51, and 2.04, respectively (p < .01). The odds of reporting higher rates of mistreatment (top 33% MIST scores) increased as BMI increased.ConclusionsWhile socio-demographic factors like race and income play significant roles in influencing perinatal care experiences, BMI remains a critical determinant even after accounting for these variables. This study reveals pronounced disparities in the provision of respectful perinatal care to pregnant individuals with higher BMIs in Canada. Data suggest that those with higher BMIs face disrespect, discrimination, and mistreatment. Identification of implicit and explicit weight bias may give providers insight enabling them to provide more respectful care.

A Systematic Review of Interventions That Aim to Reduce Implicit and Explicit Weight Biases among Fitness Professionals

Despite the high prevalence of weight bias among fitness professionals, few resources are currently available to educate fitness professionals about weight bias and no systematic review of weight bias interventions has been conducted among this population. This paper therefore reviewed extant weight bias interventions for fitness professionals to inform future weight bias-reduction initiatives. Seven reports comprising six studies were identified from inception until April 2024. Findings showed small to large improvements in explicit weight bias, particularly on the weight control/blame component. No improvements were observed in implicit weight bias. The results show an urgent need to bridge the gap between the resources currently available in the fitness industry and those developed by the scientific community and to develop novel multifaceted interventions that draw from multiple theories of attitude and behavior change to effectively tackle weight bias among fitness professionals.

Efficacy of interventions aimed at reducing explicit and implicit weight bias in healthcare students: A systematic review and meta-analysis.

We conducted a systematic review and meta-analysis to determine the efficacy of interventions aimed at reducing weight bias in healthcare students, and to explore factors that may impact intervention success. A systematic review and random-effects meta-analyses were conducted by including studies that examined the efficacy of weight bias reduction interventions for healthcare students. Of the 3463 journal articles and dissertations screened, 67 studies (within 64 records) met inclusion criteria, with 35 studies included in the meta-analyses (explicit = 35, implicit [and explicit] = 10) and 32 studies included in the narrative synthesis (explicit = 34, implicit [and explicit] = 3). Weight bias interventions had a small but positive impact, g = -0.31 (95% CI = -0.43 to -0.19, p < 0.001), in reducing students' explicit weight bias but there was no intervention effect on implicit weight bias, g = -0.12 (95% CI = -0.26 to 0.02, p = 0.105). There was considerable heterogeneity in the pooled effect for explicit bias (I2 = 74.28, Q = 132.21, df = 34, p < 0.001). All subgroup comparisons were not significant (p > 0.05) and were unable to explain the observed heterogeneity. Narrative synthesis supported meta-analytic findings. The small but significant reduction of explicit weight bias encourages the continued testing of interventions, irrespective of variation in individual intervention components. Contrarily, reductions in implicit weight bias may only be possible from a large societal shift in negative beliefs and attitudes held towards people living in larger bodies.

Weight Bias in the Perinatal Period: An Integrative Review

ABSTRACTBackgroundWeight bias toward individuals with higher body weights in healthcare settings is associated with adverse health behaviors, reduced healthcare utilization, and poor health outcomes. The purpose of this integrative review was to explore: (1) What has been measured and described regarding perinatal care providers' and students' weight bias toward pregnant, birthing, and postpartum individuals with higher body weights? (2) What has been measured and described regarding pregnant, birthing, and postpartum individuals' experiences of weight bias? (3) What is the association of experiences of weight bias with perinatal and mental health outcomes among pregnant, birthing, and postpartum individuals?MethodsWe conducted a systematic search in CINAHL, PubMed, and PsycINFO databases to identify relevant research publications related to the Medical Subject Headings (MeSH) terms weight prejudice (and related terms) and pregnancy (and related terms). The review was guided by the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA), Johns Hopkins Nursing Evidence‐Based Practice model for study quality determination, and the Whittemore and Knafl integrative review framework for data extraction and analyses.ResultsTwenty‐two publications met inclusion criteria, representing six countries and varying study designs. This review found pervasive sources of explicit weight bias in the perinatal period, including care providers and close relationships. Experiences of weight bias among pregnant and postpartum individuals are associated with adverse perinatal and mental health outcomes.DiscussionThe findings address a knowledge gap regarding a summary of literature on weight bias in the perinatal period and elucidate its prevalence as well as its negative influence on perinatal and mental health outcomes. Future research efforts on this topic must examine the nature and extent of perinatal care providers' weight bias by demographic factors and explore its association with clinical decision‐making and perinatal and mental health outcomes.

'My words would have more weight': exploring weight stigma in UK dietetic practice and dietitian's lived experiences of weight stigma.

Weight stigma is pervasive within healthcare and negatively impacts both access to care and the patient-practitioner relationship. There is limited evidence on weight stigma among registered dietitians, particularly in the United Kingdom, though data show weight-related prejudice towards people living with obesity. The aim of this study was to examine both explicit and implicit weight stigma in practicing dietitians in the United Kingdom, as well as the lived experience of weight stigma among dietitians, both towards themselves and towards others. An online cross-sectional survey was disseminated between February and May 2022 using snowball sampling. Inclusion criteria were that participants were UK registered dietitians aged 20-70 years. Four hundred and two dietitians responded to the survey (female [94.1%], mean age 40.2 years [standard deviation (SD) 10.7]; White ethnicity [90%]; median 12 years [interquartile range (IQR) 6, 22] within dietetic practice). Mean self-reported body mass index was 25.1 kg/m² (SD 8.7). Most dietitians reported experiencing weight stigma prior to (51%) and postregistration (59.7%), whereas nearly a quarter (21.1%) felt that weight influenced their ability as a dietitian. Weight stigma was experienced across the weight spectrum. Overall participants reported explicit weight bias attitudes, moderate beliefs that obesity is controllable and implicit antifat bias. Within open-ended responses, dietitians reported three key themes related to their personal experiences of weight stigma: (1) experiences of stigma in dietetic practice, (2) impact of weight stigma and (3) perception of weight, appearance and job. This study shows that UK dietitians exhibit both explicit and implicit weight bias towards people living with obesity. Dietitians reported experiencing weight stigma, which impacted their career-related decisions and their perception of their own ability to perform as dietitians. The study highlights the need to address weight stigma and its implications within the dietetic profession.

Weight bias among Canadians: Associations with sociodemographics, BMI and body image constructs

This cross-sectional study examined the associations between sociodemographic characteristics, BMI, and body image constructs (body satisfaction and weight bias internalization; WBI) and explicit weight bias. A near-representative sample of 995 English-speaking Canadian adults (52% Female) completed a survey which assessed explicit weight bias (Anti-Fat Attitudes questionnaire), body satisfaction (Body Shape Satisfaction Scale), WBI (Modified Weight Bias Internalization Scale), and self-reported height and weight. Multiple linear regression analyses were run. Results showed that the variable that explained the most variance in explicit weight bias was WBI, followed by BMI. Higher levels of WBI and a lower BMI were both significantly associated with greater explicit weight bias. Male sex was associated with both disliking people with obesity and thinking obesity is attributable to lack of willpower, whereas female sex was associated with worrying about weight gain. The current findings emphasize the importance of future research efforts aimed at preventing or mitigating WBI to reduce negative attitudes about people with obesity.

Does a person's body size and the application type influence healthcare students' perceptions of technologies to promote physical activity? Findings from a cross-sectional study

BackgroundRecent evidence suggests that weight bias may be pervasive, even among health professionals specialized in obesity, including healthcare students. Technology-based physical activity interventions are promising for people with obesity, specifically when they are theory-driven (e.g., autonomy-supportive as described by self-determination theory). However, perceptions of these technologies have been understudied among healthcare students and professionals. ObjectiveThe purpose of this study was to examine the influence of a person's body size based on body mass index and technology type on healthcare students' perceptions. DesignThis is a cross-sectional, experimental study. Participants and methodsFive hundred and two healthcare students (360 females, 142 males; mean age = 23.3, SD = 5.0) were randomly exposed to one of four scenarios that manipulated a hypothetical person's body mass index (22 kg/m2 vs. 42 kg/m2) and a technology-based physical activity type based on self-determination theory (autonomy-supportive app vs. controlling app). They then completed measures of their perceptions of the person's app acceptability and self-efficacy and of their intention to recommend the app. Multivariate and univariate analyses of covariance were performed. ResultsStudents exposed to the larger-bodied people (42 kg/m2) versus the smaller-bodied people (22 kg/m2) perceived a lower level of person's app acceptability (i.e., higher social influence and less enjoyment in using the app), as well as a lower level of self-efficacy to use the technology. Students exposed to the controlling app were more likely to recommend it compared to those exposed to the autonomy-supportive app. ConclusionsThese results suggest that healthcare students' attitudes may be negatively influenced by explicit weight bias. Also, in contrast to self-determination theory precepts, a controlling app may be more frequently recommended. Further study of healthcare students' implicit attitudes toward technology is needed.

Preliminary evaluation of a brief worksite intervention to reduce weight stigma and weight bias internalization

Weight-based discrimination (WBD) is common and associated with reduced physical and emotional functioning. WBD is common in the workplace, yet no studies have evaluated a WBD intervention delivered in a worksite setting. This study evaluated the feasibility, acceptability, and preliminary effectiveness of a 3-hour, remote-delivered WBD intervention at a large public university. Six workshops including 94 participants (41.76 ± 9.37 y; 92.8% women) were delivered December 2020 through May 2021; 88.3% of participants enrolled in the study and 88.8% of enrolled participants completed pre- and post-intervention surveys. Participants strongly agreed the workshop contributed to a more inclusive work environment (M=4.98 ± 0.2; 1 =Strongly Disagree to 5 =Strongly Agree); and was highly needed (4.9 ± 0.3) and liked (4.8 ± 0.5). Qualitative feedback cited benefits of remote delivery in providing body size anonymity and wanting access to intervention materials and more time for discussion and action steps to reduce WBD. Participants experienced significant, medium reductions in explicit weight bias (ps < .001), significant, small reductions in weight bias internalization (p < .001), and statistically non-significant (p = .08), small-to-medium reductions in implicit bias. Targeting worksites as a delivery mechanism has the potential to reduce WBD, thereby improving the health and well-being of diverse employees and creating a more inclusive workspace.

Is Obesity a Cause for Shame? Weight Bias and Stigma among Physicians, Dietitians, and Other Healthcare Professionals in Poland-A Cross-Sectional Study.

Weight bias and weight stigma pose significant challenges in healthcare, particularly affecting obesity management practices and patient care quality. Our study evaluates their prevalence and impact among healthcare professionals in Poland. Using the Fat Phobia Scale and custom questions, we surveyed 686 professionals via Computer-Assisted Web Interview (CAWI). Results reveal a moderate level of explicit weight bias (mean score: 3.60 ± 0.57), with significant variations across professional groups: physicians (3.70 ± 0.48), dietitians (3.51 ± 0.48), and others (3.44 ± 0.77). Common feelings towards individuals with obesity include willingness to help (57.0%) and compassion (37.8%), yet 29.9% perceive obesity as shameful. The results also vary depending on the respondent's sex or BMI. These findings underscore the need for evidence-based interventions to mitigate weight stigma and enhance understanding of obesity among healthcare professionals.

Explicit Weight Bias Concerns in the Fitness Industry: A Quantitative Analysis

Limited and conflicting research is available regarding weight biases in the fitness industry, yet implications of such biases are pervasive. Individuals in larger bodies often experience stigma and prejudices due to their weight, and anti-fat attitudes have been normalized in the fitness industry and associated educational pipelines. Current literature on weight biases in the fitness industry lacks context and fails to examine these biases from an intersectional lens. Therefore, this study explored how social identities (e.g., age, gender, race, etc.) influence weight biases in fitness professionals. Fitness professionals completed an electronic survey that included demographic questions and measures of weight bias (Anti-Fat Attitudes Test; AFAT) and body dissatisfaction (Contour Drawing Rating Scale). Women in the healthy (2.02 $\pm$ 0.51) and overweight (1.97 $\pm$ 0.49) BMI categories had significantly greater total AFAT scores ($p = .003$ and $p = .023$, respectively) compared to women in the obese BMI category (1.63 $\pm$ 0.48). For participants who had completed some college, those who were classified in the healthy BMI category had significantly greater total AFAT scores (2.05 $\pm$ 0.50) compared to those in the overweight BMI category (1.72 $\pm$ 0.46). For participants who completed a master’s degree, those in the healthy BMI category (2.08 $\pm$ 0.56) and overweight BMI category (2.05 $\pm$ 0.43) had significantly greater total AFAT scores compared to those in the obese BMI category (1.48 $\pm$ 0.46). There was a direct effect of gender, body dissatisfaction, race, and BMI on AFAT subscales. There was also a significant direct effect of body dissatisfaction on AFAT subscales. Across all variables, AFAT scores were highest for the physical subscale (2.69 $\pm$ 0.91) and lowest for the social subscale (1.43 $\pm$ 0.45). Fitness professionals exhibit explicit weight biases, and future research should examine the implications of such biases.

Implicit and Explicit Weight Bias among Midwives: Variations Across Demographic Characteristics.

Weight bias toward individuals with higher body weights is present in health care settings. However, there has been limited quantitative exploration into weight bias among perinatal care providers and its potential variations based on demographic characteristics. The aim of this study was to examine if the direction and extent of weight bias among midwives certified by the American Midwifery Certification Board (AMCB) varied across age, years since certification, body mass index (BMI), race, ethnicity, and US geographic region. Through direct email listservs, postcard distribution, social media accounts, and professional networks, midwives were invited to complete an online survey of their implicit weight bias (using the Implicit Association Test) and their explicit weight bias using the Anti-Fat Attitudes Questionnaire (AFA), Fat Phobia Scale (FPS), and Preference for Thin People (PTP) measure. A total of 2106 midwives who identified as Black or White and resided in one of 4 US geographic regions participated in the survey. Midwives with a lower BMI expressed higher levels of implicit (P <.01) and explicit (P ≤.01) weight bias across all 4 measures except for the AFA Fear of Fat Subscale. Implicit weight bias levels also varied by age (P <.001) and years since certification (P <.001), with lower levels among younger midwives (vs older) and those with fewer years (vs more) since certification. Only age and BMI remained significant (P <.001) after adjusting for other demographic characteristics. Lower explicit weight bias levels were found among midwives who identified as Black (vs White) on 2 measures (FPS: adjusted β = -0.07, P =.004; PTP: P =.01). This was the first quantitative study of how weight bias varies across demographic characteristics among a national sample of midwives. Further exploration is needed in more diverse samples. In addition, research to determine whether weight bias influences clinical decision-making and quality of care is warranted.

Weight Bias Among Certified Nurse-Midwives and Certified Midwives: Findings From a National Sample.

Weight bias toward individuals with higher body weights permeates health care settings in the United States and has been associated with poor weight-related communication and quality of care as well as adverse health outcomes. However, there has been limited quantitative investigation into weight bias among perinatal care providers. Certified nurse-midwives (CNMs)/certified midwives (CMs) attend approximately 11% of all births in the United States. The aims of this study were to measure the direction and extent of weight bias among CNMs/CMs and compare their levels of weight bias to the US public and other health professionals. Through direct postcard distribution, social media accounts, professional networks, and email listservs, American Midwifery Certification Board (AMCB)-certified midwives were solicited to complete an online survey of their implicit weight bias using the Implicit Association Test and their explicit weight bias using the Antifat Attitudes Questionnaire, Fat Phobia Scale, and Preference for Thin People measure. A total of 2257 midwives participated in the survey, yielding a completion rate of 17.7%. Participants were mostly White and female, with a median age of 46 years and 11 years since AMCB certification. More than 70% of midwives have some level of implicit weight bias, although to a lesser extent compared with previously published findings among the US public (P <.01) and other health professionals (P <.01). In a subsample comparison of female midwives to female physicians, implicit weight bias levels were similar (P >.05). Midwives also express explicit weight bias, but at lower levels than the US public and other health professionals (P <.05). This study provides the first quantitative research documenting weight bias among a national US sample of perinatal care providers. Findings can inform educational efforts to mitigate weight bias in the perinatal care setting and decrease harm.

Exploring weight bias and negative self-evaluation in patients with mood disorders: insights from the BodyTalk Project.

Negative body image and adverse body self-evaluation represent key psychological constructs within the realm of weight bias (WB), potentially intertwined with the negative self-evaluation characteristic of depressive symptomatology. Although WB encapsulates an implicit form of self-critical assessment, its exploration among people with mood disorders (MD) has been under-investigated. Our primary goal is to comprehensively assess both explicit and implicit WB, seeking to reveal specific dimensions that could interconnect with the symptoms of MDs. A cohort comprising 25 MD patients and 35 demographically matched healthy peers (with 83% female representation) participated in a series of tasks designed to evaluate the congruence between various computer-generated body representations and a spectrum of descriptive adjectives. Our analysis delved into multiple facets of body image evaluation, scrutinizing the associations between different body sizes and emotionally charged adjectives (e.g., active, apple-shaped, attractive). No discernible differences emerged concerning body dissatisfaction or the correspondence of different body sizes with varying adjectives. Interestingly, MD patients exhibited a markedly higher tendency to overestimate their body weight (p = 0.011). Explicit WB did not show significant variance between the two groups, but MD participants demonstrated a notable implicit WB within a specific weight rating task for BMI between 18.5 and 25 kg/m2 (p = 0.012). Despite the striking similarities in the assessment of participants' body weight, our investigation revealed an implicit WB among individuals grappling with MD. This bias potentially assumes a role in fostering self-directed negative evaluations, shedding light on a previously unexplored facet of the interplay between WB and mood disorders.

The role of social norms, intergroup contact, and ingroup favoritism in weight stigma.

Although average body size in the U.S. has increased in recent decades, stigma directed at individuals with higher weight has not diminished. In this study, we explored this phenomenon by investigating the relationship between people's perceived social norms regarding higher weight and their reported levels of weight bias (i.e., anti-fat attitudes). Our predictions for perceived social norms drew on the concepts of intergroup contact and ingroup favoritism, which were also probed in this study. We hypothesized that both greater descriptive norms and more favorable injunctive norms regarding higher weight would be associated with lower reported weight bias. Individuals' quantity and quality of social contact with people with higher weight were also predicted to be associated with lower weight bias. Finally, we predicted that individuals who perceived themselves as heavier would display ingroup favoritism (i.e., report less weight bias). Participants (N = 272) from the United States completed a set of online questionnaires about their perceived social norms, social contact with people with higher weight, and explicit weight bias. We found support for each of these pre-registered predictions (ps < 0.03), and post hoc analyses revealed that quality, but not quantity, of social contact with individuals with higher weight was an important predictor of lower weight bias. Together, these findings provide insight into the social psychology of weight bias and help to lay a theoretical foundation for future efforts to reduce weight stigma.

A multifaceted training tool to reduce weight bias among healthcare students: A randomized controlled trial

BackgroundWeight bias toward people with obesity (PwO) is common in healthcare settings. Efforts to address weight bias in healthcare settings should begin during university studies. This study aimed to explore the effect of a multifaceted intervention on weight bias among undergraduate healthcare students. MethodsAn open label randomized controlled trial. The intervention tool consisted of short video lectures on obesity, vignettes simulating interactions between health professionals and PwO, and open discourse with a PwO. The control group received a short-written document on obesity. Online questionnaires on Anti-Fat Attitudes ('AFA'), short form of the Fat-Phobia Scale ('FPS'), Weight Implicit Association Test ('Weight-IAT'), and knowledge about obesity were administered at baseline, 1-week, and 6-week post-intervention. ResultsA total of 162, 152, and 146 students participated in the study at baseline, 1-week, and 6-week post-intervention, respectively. Their mean age was 25.8 ± 6.7 years and 88.3% were women. Means of AFA total scores and FPS scores decreased significantly over time only within the intervention group (P Time*Group = 0.002 and 0.014). Both groups showed a similar trend over time in mean scores of Weight-IAT (P Time*Group = 0.868) and knowledge about obesity (P Time*Group = 0.115). ConclusionsA multifaceted intervention resulted in a significant reduction in explicit weight bias but did not yield any additional advantages over the control group in implicit weight bias and knowledge about obesity. ClinicalTrials.gov numberNCT05482802.

Pediatric healthcare professionals' attitudes and beliefs about weight stigma: A descriptive study

PurposeChildren face weight-based stigma from their healthcare providers at a disconcerting rate, and efforts to mitigate this have been scant. This study aimed to quantify pediatric healthcare professionals' attitudes and beliefs about weight stigma and to determine stigma reduction interventions that are most supported by pediatric healthcare providers. Design and methodsParticipants completed two validated instruments which measured implicit and explicit weight bias, respectively. They then completed a researcher-designed questionnaire to assess their attitudes and beliefs about weight stigma, and demographic questions. ANOVA models were used to examine associations between bias measures and participant characteristics, chi-square analyses were used to examine associations between questionnaire responses and participant characteristics, and Spearman's rank was used to determine correlations between weight bias and questionnaire responses. ResultsParticipants exhibited moderate-to-high levels of implicit and explicit weight bias (mean Implicit Association Test score = 0.59, mean Crandall Anti-Fat Attitudes Score = 38.95). Associations were noted between implicit bias and years in practice (p < 0.05), and implicit bias and occupation (p < 0.05). There was a significant correlation between explicit bias and multiple questionnaire items, suggesting that healthcare providers with greater weight bias are aware of those biases and are ready to take action to address them. ConclusionThough pediatric healthcare exhibit weight-based biases, they are invested in taking steps to mitigate these biases and their impact on patients. Practice implicationsThe results of this study can inform the design of future interventions that aim to reduce healthcare-based weight bias, thus improving the quality of pediatric healthcare.

Supplemental Material for Assessing Explicit Weight Bias Among Australian Health Care Students: Suitability of the Beliefs About Obese Persons Scale (BAOP) and the Antifat Attitudes Questionnaire (AFA)

Supplemental Material for Assessing Explicit Weight Bias Among Australian Health Care Students: Suitability of the Beliefs About Obese Persons Scale (BAOP) and the Antifat Attitudes Questionnaire (AFA)

Assessing explicit weight bias among Australian health care students: Suitability of the Beliefs About Obese Persons Scale (BAOP) and the Antifat Attitudes Questionnaire (AFA).

Assessing explicit weight bias among Australian health care students: Suitability of the Beliefs About Obese Persons Scale (BAOP) and the Antifat Attitudes Questionnaire (AFA).

Comparisons of Explicit Weight Bias Across Common Clinical Specialties of US Resident Physicians.

Patients with high body weight are persistently stigmatized in medical settings, with studies demonstrating that providers endorse negative stereotypes of, and have lower regard for, higher-weight patients. Very little is known about how this weight bias varies across specialties. The purpose of this study is to examine how explicit weight bias varies between resident providers among sixteen of the largest residency specialties in the USA. The identification of these differences will guide the prioritization and targeting of interventions. The current study utilized cross-sectional, observational data. Forty-nine allopathic medical schools were recruited to participate in this national, longitudinal study. The current study utilized data from 3267 trainees in Year 2 of Residency among those who specialized in one of the most common sixteen residency programs in 2016. Participants reported demographic information and residency specialties and completed three sets of measures pertaining to explicit weight bias. A significant minority (13-48%) of residents reported slight-to-strong agreement with each anti-fat statement. There was a significant relationship between residency specialty and anti-fat blame (F(15, 3189 = 12.87, p < .001), η2 = .06), anti-fat dislike (F(15, 3189 = 7.01, p < .001), η2 = .03), and attitudes towards obese patients (F(15, 3208 = 17.78, p < .001), η2 = .08). Primary care residents(e.g., family medicine, pediatrics) consistently reported lower levels of weight bias than those in specialty programs (e.g., orthopedic surgery, anesthesiology). This study is the first to report on weight bias in a large, heterogeneous sample of US resident physicians. Problematic levels of weight bias were found in all specialties, with residents in specialty programs generally reporting more bias than those in primary care residencies. Future research should examine which factors contribute to these differences to guide intervention.

Fat Phobia Among Youth Sport Coaches

Body weight is a common reason youth face stigma, yet it has received little attention from athletic coaches working closely with youth of diverse sizes. The present study assessed weight bias in middle and high school athletic coaches ( N = 320) via a survey of demographic characteristics and explicit weight bias ( Fat Phobia Scale-Short Form). Results indicate moderate levels of bias ( M = 3.44, SD = 0.42), with mean scores slightly lower compared to general community samples, yet higher than other specialized groups, and not varying based on the gender of the coach, the gender of the athletes coached, or the type of sport. Psychometric properties of the Fat Phobia Scale-Short Form were assessed through confirmatory factor analysis, suggesting a one-factor model as too simplistic. Implications for future research on this topic are explored, noting the importance of coaches understanding biases and the implications of bias on coaching practices.