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Program may reduce physician bias towards obesity

Convincing a medical professional to think of obesity as being a treatable condition lowered the bias they had towards people with obesity, according to research that recently appeared in the Journal of the American Osteopathic Association.

“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. 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,'" Michael Clearfield, DO, dean of Touro University’s College of Osteopathic Medicine in Vallejo, California, said in press release. “I think it’s pretty obvious that what we’ve been doing isn’t working.”

According to the release, in 2000 the rate of obesity in the United States was 15%; it now stands between 37% and 38%. Researchers also noted that health care professionals who have an “inherent” bias toward their patients who are obese could be causing difficulties in assessing and treating these patients.

Clearfield and colleagues developed a curriculum focused on chronic disorders linked to obesity; nonpharmacologic and pharmacologic approaches; metabolic factors such as behavior modification, self-control, physical activity, diet and nutrition; pathophysiology; biochemistry; pathogenesis; and obesity-related epidemiology.

They surveyed 718 first-year through fourth-year students at Touro University to determine their mindsets towards obesity before the curriculum, immediately after finishing with the course, and annually until graduation among the graduating classes of 2015 through 2018. Students who were members of graduating classes of 2013 and 2014 did not finish the curriculum and were given an examination to determine baseline values so they could serve as the control group.

Clearfield and colleagues wrote that test scores showed a significant increase in medical knowledge regarding obesity in 72.4% of year 2015 students, 92.6% of year 2016 students, 91.1% of year 2017 students and 89% of year 2018 students. In the control group, only 47.2% of year 2013 students, and 52.6% of year 2014 students, showed such increases in knowledge.

When using the Fat Phobia Scale, researchers also noted that in all 4 years observed, there was a significant reduction in bias among first-year medical students after the obesity curriculum compared with before: year 2014 students, 3.65 vs. 3.47; year 2015 students, 3.76 vs. 3.38; year 2016 students, 3.57 vs. 3.34; and year 2017 students, 3.61 vs. 3.37. In addition, the lowering of bias was significantly maintained during the fourth year.

"With an improved diet, we can get measurably healthier in just 7 to 10 days,” Clearfield said in the release. “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.”

Researchers stated that they intend to make their program available to other medical schools and residency programs. They also plan to assess outcomes among patients whose health care providers completed the curriculum. – by Janel Miller

Disclosure: The researchers reported no relevant financial disclosures.