Stigma Among Medical Students' towards Overweight and Obesity

Introduction: Overweight and obese individuals are frequently confronted with weight-bias and discrimination. Medical students and other health care professionals have been identified as a major source of stigmatisation. As data on medical students' attitudes towards overweight and obesity stem almost exclusively from the USA and Australia and work from Europe is scarce medical students' attitudes were investigated at Leipzig University in Leipzig, Germany.

Methods: A paper-pencil-survey was conducted among a non-randomized convenience sample (n=715) of medical students at Leipzig University from April to July 2011. Key element of the questionnaire was an experimental manipulation consisting of a pair of vignettes depicting an obese and a normal weight 42-year-old woman, respectively. Each vignette was followed by the Fat Phobia Scale (FPS), a semantic differenzial assessing participants' weight related attitudes. In case of the overweight vignette a panel of questions on causal attribution for the woman's overweight preceded the semantic differenzial.

Results: Factor analysis revealed that a “positive energy balance” was rated as the most relevant cause for the woman's overweight, followed by “sloppy personality trait” and “societal and social environment”. “Biomedical causes” were perceived as least relevant. The overweight vignette was rated significantly more negative as compared to the normal weight vignette (mean FPS score 3.65±0.45 versus 2.54±0.38, p<0.001). A significantly higher proportion of students had negative attitudes towards the overweight as compared to the normal weight individual (98.9% versus 53.7%, p<0.001). In linear regression, attributing a “positive energy balance” or “sloppy personality trait” as relevant causes for overweight was positively associated with negative attitudes towards the overweight vignette.

Discussion: This study confirms that stigmatizing attitudes towards overweight and obesity are prevalent among a sample of German medical students. These negative attitudes arise on the basis of holding the individual accountable for the excess weight. The results of this study call for bringing the topic of overweight and obesity more into the focus of the medical curriculum, for enhancing medical students' awareness of the complex aetiology of this health-condition and for developing anti-stigma interventions targeting medical students.