Implicit and explicit weight bias among medical students: A cross-sectional study

Objectives Obesity is a major public health challenge in India and globally. Weight bias, negative attitudes toward individuals with obesity, can be explicit or implicit and may influence clinical care, but evidence among Indian medical students is scarce. To determine the prevalence of implicit and explicit weight bias among undergraduate medical students and explore associated factors. Material and Methods This cross-sectional study recruited 140 second- and final-year MBBS students at the University College of Medical Sciences, Delhi, over 18 months. Participants completed a paper-based implicit association test (IAT) and validated scales (anti-fat attitudes [AFA], beliefs about obese persons [BAOP], attitudes toward obese persons [ATOP]) to assess explicit attitudes, along with empathy and confidence questionnaires. Sociodemographic and weight-related variables were recorded. Results The mean age was 22.1 ± 1.4 years, and 29.3% were female. Implicit weight bias was present in 56.4% (95% CI:48.1-64.5) of students, whereas explicit AFA were present in 23.6% (95% CI:16.6-30.6). Most students (82.9%) endorsed multifactorial causes of obesity, while 32.1 % held favorable attitudes toward people with obesity. High empathy and confidence were reported in 39.3 and 27.8%, respectively. Bias prevalence did not differ by age, gender, self-perceived weight or desire to lose weight. Experiences of weight-related teasing and reliance on family and peers for information showed non-significant trends toward higher bias. Conclusion More than half of Indian medical students displayed implicit anti-obesity bias, despite relatively low explicit AFA. Educational strategies addressing unconscious bias and fostering respectful care are needed.