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Journal of General Internal Medicine
Published in: Journal of General Internal Medicine 9/2015

Open Access 01-09-2015 | Original Research

The Adverse Effect of Weight Stigma on the Well-Being of Medical Students with Overweight or Obesity: Findings from a National Survey

Authors: Sean M. Phelan, Ph.D., MPH, Diana J. Burgess, Ph.D., Rebecca Puhl, Ph.D., Liselotte N. Dyrbye, M.D., John F. Dovidio, Ph.D., Mark Yeazel, M.D., Jennifer L. Ridgeway, MPP, David Nelson, Ph.D., Sylvia Perry, Ph.D., Julia M. Przedworski, B.S., Sara E. Burke, MS, MPhil, Rachel R. Hardeman, Ph.D., MPH, Michelle van Ryn, Ph.D., MPH

Published in: Journal of General Internal Medicine | Issue 9/2015

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ABSTRACT

BACKGROUND

The stigma of obesity is a common and overt social bias. Negative attitudes and derogatory humor about overweight/obese individuals are commonplace among health care providers and medical students. As such, medical school may be particularly threatening for students who are overweight or obese.

OBJECTIVE

The purpose of our study was to assess the frequency that obese/overweight students report being stigmatized, the degree to which stigma is internalized, and the impact of these factors on their well-being.

DESIGN

We performed cross-sectional analysis of data from the Medical Student Cognitive Habits and Growth Evaluation Study (CHANGES) survey.

PARTICIPANTS

A total of 4,687 first-year medical students (1,146 overweight/obese) from a stratified random sample of 49 medical schools participated in the study.

MAIN MEASURES

Implicit and explicit self-stigma were measured with the Implicit Association Test and Anti-Fat Attitudes Questionnaire. Overall health, anxiety, depression, fatigue, self-esteem, sense of mastery, social support, loneliness, and use of alcohol/drugs to cope with stress were measured using previously validated scales.

KEY RESULTS

Among obese and overweight students, perceived stigma was associated with each measured component of well-being, including anxiety (beta coefficient [b] = 0.18; standard error [SE] = 0.03; p < 0.001) and depression (b = 0.20; SE = 0.03; p < 0.001). Among the subscales of the explicit self-stigma measure, dislike of obese people was associated with several factors, including depression (b = 0.07; SE = 0.01; p < 0.001), a lower sense of mastery (b = −0.10; SE = 0.02; p < 0.001), and greater likelihood of using drugs or alcohol to cope with stress (b = 0.05; SE = 0.01; p < 0.001). Fear of becoming fat was associated with each measured component of well-being, including lower body esteem (b = −0.25; SE = 0.01; p < 0.001) and less social support (b = −0.06; SE = 0.01; p < 0.001). Implicit self-stigma was not consistently associated with well-being factors. Compared to normal-weight/underweight peers, overweight/obese medical students had worse overall health (b = −0.33; SE = 0.03; p < 0.001) and body esteem (b = −0.70; SE = 0.02; p < 0.001), and overweight/obese female students reported less social support (b = −0.12; SE = 0.03; p < 0.001) and more loneliness (b = 0.22; SE = 0.04; p < 0.001).

CONCLUSIONS

Perceived and internalized weight stigma may contribute to worse well-being among overweight/obese medical students.
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Metadata
Title
The Adverse Effect of Weight Stigma on the Well-Being of Medical Students with Overweight or Obesity: Findings from a National Survey
Authors
Sean M. Phelan, Ph.D., MPH
Diana J. Burgess, Ph.D.
Rebecca Puhl, Ph.D.
Liselotte N. Dyrbye, M.D.
John F. Dovidio, Ph.D.
Mark Yeazel, M.D.
Jennifer L. Ridgeway, MPP
David Nelson, Ph.D.
Sylvia Perry, Ph.D.
Julia M. Przedworski, B.S.
Sara E. Burke, MS, MPhil
Rachel R. Hardeman, Ph.D., MPH
Michelle van Ryn, Ph.D., MPH
Publication date
01-09-2015
Publisher
Springer US
Published in
Journal of General Internal Medicine / Issue 9/2015
Print ISSN: 0884-8734
Electronic ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-015-3266-x

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