New study highlights the modest impact of weight bias reduction interventions in healthcare students
A new systematic review and meta-analysis, published in our journal Obesity Reviews, explores the effectiveness of interventions designed to reduce weight bias among healthcare students.
The study, conducted by an international team of researchers, sheds light on the modest success of these interventions in reducing explicit weight bias but finds no significant impact on implicit bias.
Weight bias among healthcare professionals is a well-documented issue that affects the quality of care for people living with overweight and obesity. It is associated with stigmatising attitudes that can lead to suboptimal medical treatment, including fewer screenings, delayed diagnosis, and poorer patient-provider communication.
This latest study, led by researchers from Curtin University, the University of Leeds, and other institutions, evaluates the effectiveness of strategies aimed at addressing these biases among healthcare students before they enter clinical practice.
Small reductions in explicit weight bias
The review analysed data from 67 studies, including 35 that were eligible for meta-analysis. The results show that interventions aimed at reducing explicit weight bias—defined as overt and controllable negative attitudes toward individuals with obesity—had a small but statistically significant impact, with an overall effect size of g = -0.31. This indicates a slight reduction in explicit bias following the interventions.
These interventions often utilised education, empathy-building exercises, and exposure to non-stigmatising narratives to target students' explicit biases. Despite the positive findings, the effect size suggests that while beneficial, these interventions have a limited ability to significantly change healthcare students' explicit attitudes towards obesity.
No impact on implicit weight bias
In contrast, the meta-analysis found that the interventions did not significantly reduce implicit weight bias. Implicit biases are more deeply ingrained, automatic attitudes that operate outside of conscious control. The pooled effect size for implicit bias reduction was g = -0.12, which was not statistically significant.
This result suggests that the existing interventions may not be robust enough to shift subconscious attitudes. The researchers point out that implicit biases are often shaped by broader societal attitudes and may require more extensive societal changes to address effectively.
Challenges in reducing implicit bias
The study highlights the difficulty in reducing implicit weight bias, noting that many interventions have focused on explicit bias, which is easier to identify and target through structured educational programmes. Implicit bias, being more deeply rooted and less consciously accessible, is harder to shift and may require longer-term and more intensive strategies.
The authors also suggest that current interventions may need to incorporate more innovative approaches, such as continuous education, implicit bias testing, and broader cultural shifts, to produce lasting changes in these attitudes.
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Future directions
While the study acknowledges the modest success in reducing explicit weight bias, it underscores the need for more comprehensive interventions that can tackle both explicit and implicit biases. The authors call for future research to explore novel methods for addressing implicit bias and for long-term follow-up studies to determine whether the observed reductions in explicit bias are sustained over time.
Additionally, the review suggests that interventions targeting healthcare students at an early stage in their training could help foster more compassionate and unbiased healthcare environments in the future.
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World Obesity publishes four scientific, peer-reviewed journals, each focusing on a different area of obesity research: systematic reviews, pediatrics, clinical treatment, and science and practice.
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