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Weight Bias Amongst Medical Students

As classes reopen and students flock back to their classes, here is an article that may be of particular interest to medical education.

In this study, published online in the International Journal of Obesity, Susan Persky and Colette Eccleston examined medical students’ care recommendations for an obese versus non-obese virtual patient.

A total of 76 clinical-level medical students were randomly assigned to interact with a digital, virtual female patient who was visibly obese or non-obese.

Studies were conducted in an immersive virtual (virtual reality) environment that allowed standardization of all patient behaviors and characteristics – all details were identical for the obese and non-obese patients (blood pressure, pulse, temperature, medications and so on) with the exception of weight and BMI. The obese patient’s weight was reported as 247 pounds with a BMI of 39.9 and the non-obese patient’s weight was reported as 134 pounds with a BMI of 21.6.

Students revealed more negative stereotyping, less anticipated patient adherence, worse perceived health, more responsibility attributed for potentially weight-related presenting complaints and less visual contact directed toward the obese version of a virtual patient than the non-obese version of the patient. Visual contact is a proxy for eye contact, a behavior that is linked to empathy expression by providers.

Interestingly though, there was no clear evidence of bias in clinical recommendations made for the patient’s care.

Student BMI was also not a significant predictor of the results of the analyses. Thus, students who had higher BMIs did not exhibit lower levels of bias.

As the authors point out, “Biases in attitudes, beliefs and interpersonal behavior have important implications because they can influence the tone of clinical encounters and rapport in the patient-provider relationship, which can have important downstream consequences.

I, for one, am not sure that the results of this study would have turned out that differently for students of other health professions. Guess it is never early enough to start addressing this issue.

Edmonton, Alberta

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Persky S, & Eccleston CP (2010). Medical student bias and care recommendations for an obese versus non-obese virtual patient. International journal of obesity (2005) PMID: 20820169


  1. I would like to see if this transfers across to corpulent male patients. This could just be beauty bias.

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  2. One of my master student performed a similar on physical education students. He found such a bias, but interestingly the bias decreased from the 1st to the 4th year (tranversal design). It to may be interesting to educate our respective students to prevent such a bias.

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  3. I wonder if this would also occur in the general (non-medical) areas as well. Maybe do it in a hiring situation where people had to interview an overweight and an average sized person with the exact same resume and see who would get hired.

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  4. For Wade Gieni:

    It’s been done before. Psychologist have studied the impact of weight in hiring decisions, and it’s been shown that women, who are overweight, are less likely to be hired when compared with women who are not overweight. I believe it’s been replicated with men as well.

    A quick google scholar search, or social psych textbook, would confirm this.



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