Obesity is pandemic throughout the world, and there is concern that physicians are inadequately trained to treat their patients with obesity despite its prevalence. This review explores obesity education in medical students, resident, and fellow physicians throughout the world from 2005 to 2018. Previous reviews on obesity education were conducted before 2011, focused solely on medical students, and only explored obesity education in the United States. We systematically searched MEDLINE, EMBASE, PsycINFO, and ERIC databases for studies which included the search terms “obesity education” AND either “medical students”, “residency”, or “fellowship” that met PICOS (Population, Interventions, Comparators, Outcomes, Study Design) criteria for articles published in English for obesity education and evaluation of outcomes. Our initial search yielded 234 articles, and 27 studies met criteria for our review. We described and analyzed these studies for their study design and graded quality, quantity, and consistency for each measured outcome. We applied an evidence grading system that has been previously applied in the literature in which each outcome measure was graded on a scale from A to D. We evaluated obesity education programs for outcomes regarding implicit and explicit bias, changes in attitude towards obesity, weight change, obesity knowledge, counseling confidence, intent to counsel, and counseling quality. There was a significant degree of heterogeneity in the studies included. While obesity knowledge was most frequently studied, counseling confidence was the only outcome with an overall grade A. There is currently a paucity of obesity education programs for medical students, residents, and fellow physicians in training programs throughout the world despite high disease prevalence. However, these programs often improve outcomes when they are administered. Our review suggests that more obesity education should be administered in undergraduate and graduate medical education to ensure optimal treatment of patients with obesity.
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Hales CM, Carroll MD, Fryar CD, Ogden CL. Prevalence of obesity among adults and youth: United States, 2015-2016.: Hyattsville, MD, 2017. NCHS Data Brief.
Galuska DA, Will JC, Serdula MK, Ford ES. Are health care professionals advising obese patients to lose weight? JAMA. 1999;282:1576–8.
Jackson SE, Wardle J, Johnson F, Finer N, Beeken RJ. The impact of a health professional recommendation on weight loss attempts in overweight and obese British adults: a cross-sectional analysis. BMJ Open. 2013;3:e003693.
Thapa R, Friderici J, Kleppel R, Fitzgerald J, Rothberg MB. Do physicians underrecognize obesity? South Med J. 2014;107:356–60.
Sebiany AM. Primary care physicians’ knowledge and perceived barriers in the management of overweight and obesity. J Fam Community Med. 2013;20:147.
Goff SL, Holmboe ES, Curry L. Barriers to obesity training for pediatric residents: a qualitative exploration of residency director perspectives. Teach Learn Med. 2006;18:348–55.
Dacey ML, Kennedy MA, Polak R, Phillips EM. Physical activity counseling in medical school education: a systematic review. Med Educ Online. 2014;19:24325.
Dang TM, Maggio LA. Supporting the call to action: a review of nutrition educational interventions in the health professions literature and MedEdPORTAL. Acad Med. 2017;92:403–16.
Kyrou IRH, Tsigos C, et al. Endotext, MDText.com: South Dartmouth (MA), 2010.
Force USPST. Behavioral weight loss interventions to prevent obesity-related morbidity and mortality in adults: Us preventive services task force recommendation statement. JAMA. 2018;320:1163–71.
Snow V, Barry P, Fitterman N, Qaseem A, Weiss K. for the Clinical Efficacy Assessment Subcommittee of the American College of P et al. Pharmacologic and Surgical Management of Obesity in Primary Care: A Clinical Practice Guideline from the American College of Physicians. Ann Inter Med. 2005;142:525–31.
O.M.A. Obesity Medicine Academy. In: ObesityMedicine Association: CME, 2018.
Rutledge T, Groesz LM, Linke SE, Woods G, Herbst KL. Behavioural weight management for the primary careprovider. Obes Rev. 2011;12:e290–e297.
Rose SA, Poynter PS, Anderson JW, Noar SM, Conigliaro J. Physician weight loss advice and patient weight loss behavior change: a literature review and meta-analysis of survey data. Int J O. 2005;37:118–28. 2013
Tan D, Zwar NA, Dennis SM, Vagholkar S. Weight management in general practice: what do patients want? Med J Aust. 2006;185:73–75.
Sanchez-Ramirez DC, Long H, Mowat S, Hein C. Obesity education for front-line healthcare providers. BMC Med Educ. 2018;18:278.
Iwamoto S, Saxon D, Tsai A, Leister E, Speer R, Heyn H, et al. Effects of education and experience on primary care providers’ perspectives of obesity treatments during a pragmatic trial: PCPs’ perspectives on obesity treatments changed. Obesity. 2018;26:1532–8.
Davila N, Vess J, Johnson EE. Identification and management of obese patients in a pediatric orthopaedic clinic. Orthop Nurs. 2017;36:194–200.
Acosta A, Azzalin A, Emmons CJ, Shuster JJ, Jay M, Lo MC. Improving residents’ clinical approach to obesity: impact of a multidisciplinary didactic curriculum. Postgrad Med J. 2014;90:630–7.
Stanford FC, Johnson ED, Claridy MD, Earle RL, Kaplan LM. The role of obesity training in medical school and residency on bariatric surgery knowledge in primary care physicians. Int J Fam Med. 2015;2015:841249–8.
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.
Phelan SM, Puhl RM, Burke SE, Hardeman R, Dovidio JF, Nelson DB, et al. The mixed impact of medical school on medical students’ implicit and explicit weight bias. Med Educ. 2015;49:983–92.
Bray GA, Kim KK, Wilding JPH, on behalf of the World Obesity F. Obesity: a chronic relapsing progressive disease process. a position statement of the world obesity federation: position paper. Obes Rev. 2017;18:715–23.
Vitolins MZ, Crandall S, Miller D, Ip E, Marion G, Spangler JG. Obesity educational interventions in U.S. Medical Schools: a systematic review and identified gaps. Teach Learn Med. 2012;24:267–72.
Chisholm A, Hart J, Mann KV, Harkness E, Peters S. Preparing medical students to facilitate lifestyle changes with obese patients: a systematic review of the literature. Acad Med. 2012;87:912–23.
Beach MC, Price EG, Gary TL, Robinson KA, Gozu A, Palacio A, et al. Cultural competence: a systematic review of health care provider educational interventions. Med Care. 2005;43:356–73.
Chisholm A, Hart J, Mann K, Perry M, Duthie H, Rezvani L, et al. Investigating the feasibility and acceptability of health psychology-informed obesity training for medical students. Psychol Health Med. 2016;21:368–76.
Swift JA, Tischler V, Markham S, Gunning I, Glazebrook C, Beer C, et al. Are anti-stigma films a useful strategy for reducing weight bias among trainee healthcare professionals? Results of a pilot randomized control trial. Obes Facts. 2013;6:91–102.
Campbell-Scherer DL, Luig T, Wicklum S, Klein D, Lafrance R, Heatherington M et al. Improving Obesity Management Education and Training for Medical Residents. Can J Diabetes 2017; 41:S22.
Wislo VMP, McGaffey A, Scopaz KA, D’Amico FJ, Jewell IK, Bridges MW, et al. Fitwits. Clinical Pediatrics. 2013;52:1107–17.
M. Burton A, Cherrington A, Agne A, Lehr S, Brezausek C. Implementing an obesity counseling curriculum in residency training, 2010;387.
Huang J, Pokala P, Hill L, Boutelle KN, Wood C, Becerra K, et al. The Health and Obesity: Prevention and Education (HOPE) Curriculum Project-Curriculum Development. Pediatrics. 2009;124:1438–46.
Matharu K, Shapiro J, Hammer R, Kravitz RL, Wilson M, Fitzgerald F. Reducing obesity prejudice in medical education. Educ Health 2014; 27:231-37.
Ockene JK, Ashe KM, Hayes RB, Churchill LC, Crawford SL, Geller AC, et al. Design and rationale of the medical students learning weight management counseling skills (MSWeight) group randomized controlled trial. Contemp Clin Trials. 2018;64:58–66.
Jay MR, Gillespie CC, Schlair SL, Savarimuthu SM, Sherman SE, Zabar SR, et al. The impact of primary care resident physician training on patient weight loss at 12 months. Obesity. 2013;21:45–50.
Laiteerapong N, Keh CE, Naylor KB, Yang VL, Vinci LM, Oyler JL, et al. A resident-led quality improvement initiative to improve obesity screening. Am J Med Qual. 2011;26:315–22.
Ren V, Ellison K, Miller J, Busireddy K, Vickery E, Panda M, et al. Effect of didactic lectures on obesity documentation and counseling among internal medicine residents. J Community Hosp Intern Med Perspect. 2016;6:30931.
Brown J, Lydecker JA, Turner T, Knackstedt RW, O’Neil PM. A novel approach to training students in delivering evidence-based obesity treatment. Fam Med. 2015;47:378–82.
Schmidt S, Rice A, Kolasa K. Teaching by example: educating medical students through a weight management experience. Fam Med. 2013;45:572–5.
Burton AM, Brezausek CM, Agne AA, Hankins SL, Willett LL, Cherrington AL. Evaluation of a workshop to improve residents’ patient-centred obesity counselling skills. Postgrad Med J. 2016;92:455–9.
Ip EH, Marshall S, Vitolins M, Crandall SJ, Davis S, Miller D, et al. Measuring medical student attitudes and beliefs regarding patients who are obese. Acad Med. 2013;88:282–9.
Gayer GG, Weiss J, Clearfield M. Fundamentals for an Osteopathic Obesity Designed Study: The Effects of Education on Osteopathic Medical Students’ Attitudes Regarding Obesity. J Am Osteopath Assoc. 2017;117:495–502.
Gonzalez JL, Gilmer L. Obesity prevention in pediatrics: A pilot pediatric resident curriculum intervention on nutrition and obesity education and counseling. J Natl Med Assoc. 2006;98:1483–8.
Stahl CE, Necheles JW, Mayefsky JH, Wright LK, Rankin KM. 5-4-3-2-1 go! Coordinating pediatric resident education and community health promotion to address the obesity epidemic in children and youth. Clin Pediatr. 2011;50:215–24.
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.
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.
Geller G, Watkins PA. Addressing medical students’ negative bias toward patients with obesity through ethics education. AMA J Ethics. 2018;20:E948–959.
McAndrew S, Jackman C, Sisto PP. Medical student-developed obesity education program uses modified team-based learning to motivate adolescents. Med Teach. 2012;34:414–6.
Rodriguez JE, Painter K. ‘Health Not Cosmetics’: a medical student obesity treatment project. Med Educ. 2006;40:1133–4.
Iyer S, Jay M, Southern W, Schlair S. Assessing and counseling the obese patient: improving resident obesity counseling competence. Obes Res Clin Pract. 2018;12:242–5.
Bell K, Cole BA. Improving medical students’ success in promoting health behavior change: a curriculum evaluation. J Gen Intern Med. 2008;23:1503.
Swift JA, Hanlon S, El-Redy L, Puhl RM, Glazebrook C. Weight bias among UK trainee dietitians, doctors, nurses and nutritionists. J Hum Nutr Diet. 2013;26:395–402.
Wiese HJ, Wilson JF, Jones RA, Neises M. Obesity stigma reduction in medical students. Int J Obes Relat Metab disord. 1992;16:859.
Association OM. Obesity Medicine Education Collaborative Competencies. In, 2019.
Recognizing and Taking Action in Response to the Obesity Crisis D-440.980. American Medical Association Annual Meeting; Chicago, Illinois, 2017.
Stewart MA. Effective physician-patient communication and health outcomes: a review. CMAJ. 1995;152:1423–33.
National Institutes of Health NIDDK P30 DK040561 and L30 DK118710.
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Mastrocola, M.R., Roque, S.S., Benning, L.V. et al. Obesity education in medical schools, residencies, and fellowships throughout the world: a systematic review. Int J Obes 44, 269–279 (2020). https://doi.org/10.1038/s41366-019-0453-6
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