Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

Behavior, Psychology and Sociology

The effects of a teaching intervention on weight bias among kinesiology undergraduate students

Abstract

Objectives

Weight bias is present among kinesiology professionals and this may cause a significant negative impact on their clients with obesity. Thus, our objective was to test if learning about uncontrollable cause of obesity and about weight bias would reduce explicit and implicit weight bias among kinesiology undergraduate students compared to the traditional curriculum which is more focused on controllable causes of weight gain.

Methods

We recruited undergraduates from two classes of the same kinesiology major course taught by the same instructor. In-class teaching activities consisted of 80 min lecture on day 1, video watching session and a group activity on day 3 for both groups. Intervention group (n = 33) learned about uncontrollable causes of obesity and about weight bias and had activities to evoke empathy. Control group (n = 34) learned the traditional curriculum where they learned the role of exercise and diet in weight management. We measured explicit and implicit weight bias using Anti-Fat Attitude Test (AFAT) and Implicit Association Test (IAT), respectively pre-intervention, immediate post intervention and 1 month later.

Results

In mixed model analysis, AFAT Blame scores had significant group by time interaction (p < 0.001). Blame scores significantly reduced with mean differences (standard error (SE)) of −0.35 (0.08) post intervention (p < 0.001) and persisted to be reduced with mean differences (SE) of −0.39 (0.08) even after 4-week follow-up (p < 0.001) only in the intervention group. Odds of having less implicit weight bias was significantly lower at 4-week follow-up than pre-intervention (odds ratio = 0.4; 95% CI: 0.22–0.73) in the control group but no changes were seen in the intervention group.

Conclusions

“Blame” component of explicit weight bias significantly decreased when students learned about controllable causes of obesity and weight bias, but implicit bias did not reduce. However, implicit weight bias appears to increase when education on obesity is limited to diet and exercise interventions as taught in the traditional curriculum.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Washington RL. Childhood obesity: issues of weight bias. Prev Chronic Dis. 2011;8:A94.

    PubMed  PubMed Central  Google Scholar 

  2. Phelan SM, Burgess DJ, Yeazel MW, Hellerstedt WL, Griffin JM, van Ryn M. Impact of weight bias and stigma on quality of care and outcomes for patients with obesity. Obes Rev. 2015;16:319–26.

    Article  CAS  Google Scholar 

  3. Ryan D, Heaner M. Guidelines (2013) for managing overweight and obesity in adults. Obesity (Silver Spring). 2014;22 Suppl 2:S1–3.

    Article  Google Scholar 

  4. Puhl RM, Heuer CA. The stigma of obesity: a review and update. Obesity. 2009;17:941–64.

    Article  Google Scholar 

  5. Puhl R, Brownell KD. Bias, discrimination, and obesity. Obes Res. 2001;9:788–805.

    Article  CAS  Google Scholar 

  6. Puhl RM, Andreyeva T, Brownell KD. Perceptions of weight discrimination: prevalence and comparison to race and gender discrimination in America. Int J Obes. 2008;32:992.

    Article  CAS  Google Scholar 

  7. Tomiyama AJ. Weight stigma is stressful. A review of evidence for the Cyclic Obesity/ Weight-Based Stigma model. Appetite. 2014;82:8–15.

    Article  Google Scholar 

  8. Robinson E, Sutin A, Daly M. Perceived weight discrimination mediates the prospective relation between obesity and depressive symptoms in U.S. and U.K. adults. Health Psychol. 2017;36:112–21.

    Article  Google Scholar 

  9. Sutin AR, Stephan Y, Terracciano A. Weight discrimination and risk of mortality. Psychol Sci. 2015;26:1803–11.

    Article  Google Scholar 

  10. Puhl RM, Heuer CA. Obesity stigma: important considerations for public health. Am J Public Health. 2010;100:1019–28.

    Article  Google Scholar 

  11. Papadopoulos S, Brennan L. Correlates of weight stigma in adults with overweight and obesity: a systematic literature review. Obesity. 2015;23:1743–60.

    Article  Google Scholar 

  12. Pearl RL, Wadden TA, Hopkins CM, Shaw JA, Hayes MR, Bakizada ZM, et al. Association between weight bias internalization and metabolic syndrome among treatment-seeking individuals with obesity. Obesity. 2017;25:317–22.

    Article  CAS  Google Scholar 

  13. Langdon J, Rukavina P, Greenleaf C. Predictors of obesity bias among exercise science students. Adv Physiol Educ. 2016;40:157–64.

    Article  Google Scholar 

  14. Chambliss HO, Finley CE, Blair SN. Attitudes toward obese individuals among exercise science students. Med Sci Sports Exerc. 2004;36:468–74.

    Article  Google Scholar 

  15. Rukavina PB, Li W, Shen B, Sun H. A service learning based project to change implicit and explicit bias toward obese individuals in kinesiology pre-professionals. Obes Facts. 2010;3:117–26.

    Article  Google Scholar 

  16. O’Brien KS, Hunter JA, Banks M. Implicit anti-fat bias in physical educators: physical attributes, ideology and socialization. Int J Obes (Lond). 2007;31:308–14.

    Article  Google Scholar 

  17. Alberga AS, Pickering BJ, Alix Hayden K, Ball GD, Edwards A, Jelinski S, et al. Weight bias reduction in health professionals: a systematic review. Clin Obes. 2016;6:175–88.

    Article  CAS  Google Scholar 

  18. van Leeuwen F, Hunt DF, Park JH. Is obesity stigma based on perceptions of appearance or character? Theory, evidence, and directions for further study. Evol Psychol. 2015;13:1–8.

    Google Scholar 

  19. Danielsdottir S, O’Brien KS, Ciao A. Anti-fat prejudice reduction: a review of published studies. Obes Facts. 2010;3:47–58.

    Article  Google Scholar 

  20. Poustchi Y, Saks NS, Piasecki AK, Hahn KA, Ferrante JM. Brief intervention effective in reducing weight bias in medical students. Fam Med. 2013;45:345–8.

    PubMed  PubMed Central  Google Scholar 

  21. Cotugna N, Mallick A. Following a calorie-restricted diet may help in reducing healthcare students’ fat-phobia. J Community Health. 2010;35:321–4.

    Article  Google Scholar 

  22. Falker AJ, Sledge JA. Utilizing a bariatric sensitivity educational module to decrease bariatric stigmatization by healthcare professionals. Bariatr Nurs Surg Patient Care. 2011;6:73–8.

    Article  Google Scholar 

  23. Kushner RF, Zeiss DM, Feinglass JM, Yelen M. An obesity educational intervention for medical students addressing weight bias and communication skills using standardized patients. BMC Med Educ. 2014;14:53.

    Article  Google Scholar 

  24. Roberts DH, Kane EM, Jones DB, Almeida JM, Bell SK, Weinstein AR, et al. Teaching medical students about obesity: a pilot program to address an unmet need through longitudinal relationships with bariatric surgery patients. Surg Innov. 2011;18:176–83.

    Article  Google Scholar 

  25. Rukavina PB, Li W, Rowell MB. A service learning based intervention to change attitudes toward obese individuals in kinesiology pre-professionals. Social Psychol Educ. 2008;11:95–112.

    Article  Google Scholar 

  26. Lewis RJ, Cash TF, Bubb-Lewis C. Prejudice toward fat people: the development and validation of the antifat attitudes test. Obes Res. 1997;5:297–307.

    Article  CAS  Google Scholar 

  27. Schwartz MB, Chambliss HON, Brownell KD, Blair SN, Billington C. Weight bias among health professionals specializing in obesity. Obes Res. 2003;11:1033–9.

    Article  Google Scholar 

  28. Robertson N, Vohora R. Fitness vs. fatness: implicit bias towards obesity among fitness professionals and regular exercisers. Psychol Sport Exerc. 2008;9:547–57.

    Article  Google Scholar 

  29. Teachman BA, Brownell KD. Implicit anti-fat bias among health professionals: is anyone immune? Int J Obes Relat Metab Disord. 2001;25:1525–31.

    Article  CAS  Google Scholar 

  30. O’Brien KS, Puhl RM, Latner JD, Mir AS, Hunter JA. Reducing anti-fat prejudice in preservice health students: a randomized trial. Obesity. 2010;18:2138–44.

    Article  Google Scholar 

  31. Glass AL, Ingate M, Sinha N. The effect of a final exam on long-term retention. J Gen Psychol. 2013;140:224–41.

    Article  Google Scholar 

  32. Puhl RM, Phelan SM, Nadglowski J, Kyle TK. Overcoming weight bias in the management of patients with diabetes and obesity. Clin Diabetes. 2016;34:44–50.

    Article  Google Scholar 

Download references

Acknowledgements

We thank all the participants who took part in this study and Hunter Turnipseed (MS) for helping with the data collection.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Emily J. Dhurandhar.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s note: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wijayatunga, N.N., Kim, Y., Butsch, W.S. et al. The effects of a teaching intervention on weight bias among kinesiology undergraduate students. Int J Obes 43, 2273–2281 (2019). https://doi.org/10.1038/s41366-019-0325-0

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41366-019-0325-0

This article is cited by

Search

Quick links