Exploring Obesity Bias in Medical Education: A Study of Third-Year Medical Students’ Clinical Experiences in the United States

<b><i>Introduction:</i></b> Patient experiences of obesity bias are commonplace in healthcare. The harmful assumptions, beliefs, and discrimination associated with obesity bias contribute to poorer health outcomes and reduced engagement in care. Furthermore, medical students are susceptible to repeating the bias and stigma they observe in medical training. This study explored medical students' observations of obesity bias during their clinical training to inform future medical education curricula development on obesity bias. <b><i>Method:</i></b> In June 2022, 173 third-year medical students completing an extensive course on obesity at George Washington University School of Medicine & Health Sciences were asked to write a reflection on the obesity bias they had observed in clinical settings prior to and during their medical school education, to date. We used inductive coding techniques to identify themes from students' observed obesity bias using the software program Dedoose Version 8.3.35. <b><i>Results:</i></b> We identified four main themes based on students' observations of obesity bias, including 1) Don't worry, it's because of your weight (undue focus on weight above other health-related issues), 2) Your weight defines your worth (equating patients' worth to their weight and justifying inadequate treatment), 3) Ok, now I can be honest (harsh and transparent stigmatizing language directed towards absent/unconscious patients), and 4) I'm just a medical student (difficulties speaking out about obesity bias as students). <b><i>Discussion:</i></b> Systematic changes for dismantling obesity bias in medical education and healthcare, more broadly, are in their infancy. This research highlights various ways obesity bias permeates healthcare as observed by medical students in addition to concerns about how patients with obesity are treated in clinical settings. In light of our findings, early intervention in medical education is needed to address and reduce obesity bias in healthcare settings, with additional educational support for practicing providers in identification and attenuation of bias towards patients and families.