Health care professionals may have an inherent bias toward patients with obesity, but educational initiatives to reduce medical students’ bias may help, according to research published in The Journal of the American Osteopathic Association.
An educational initiative at Touro University College of Osteopathic Medicine in California (TUCOM) is reducing medical students’ negative attitudes toward people with obesity, a finding researchers hope will translate into better outcomes for patients struggling with weight, according to the research, which appeared in the JAOA’s August issue.
The study suggests that shifting physicians’ perspective from individual responsibility to a treatable condition may impact and finally slow decades of rising obesity rates.
“We know there are economic, cultural, political and environmental elements causing this problem, yet our approach to treatment puts sole responsibility on the patient’s behavior,” says Michael Clearfield, DO, dean of TUCOM. “It’s not unlike the way we treated depression 40 years ago. Only, instead of telling people to ‘get over it’, we say, ‘just eat right and exercise.’”
The curriculum at TUCOM, which launched in 2012, gauges medical students’ attitudes on the Fat Phobia Scale, which measures biased beliefs in stereotypes.
The students then receive instruction on the causes and treatments of obesity, with follow-up testing on their knowledge and attitudes toward obesity for every year of medical school. Researchers found that students who completed the program significantly reduced their bias by an average of 7 percent.
Changing hearts and minds
Dr. Clearfield noted that confronting physicians’ conscious and unconscious biases may change the dynamic for their patients.
“Sometimes physicians don’t believe that obese people will take care of themselves, so they spend less time with them and, as a result, they miss things in their examinations,” says Dr. Clearfield.
He adds that patients pick up on physicians’ attitudes and feel embarrassed and unwelcome, and so they often stop following medical advice and maybe stop going in for checkups altogether.
TUCOM’s obesity education curriculum focuses on the complexities of obesity, with diet being only one contributing factor. The curriculum also emphasizes a focus on attaining health instead of weight loss, as well as the recognition of incremental improvements.
“With an improved diet, we can get measurably healthier in just 7 to 10 days. From an osteopathic perspective, we need to acknowledge the importance of those small steps so physicians don’t give up on patients and patients don’t give up on themselves.”
Based on the results from the four year study, TUCOM plans to expand its curriculum to an online platform, making it available to other medical schools and residency programs. Ultimately, they intend to study its impact on patient outcomes.