Medical students' attitudes towards overweight and obesity

Effects of active video games on physical activity among overweight and obese college students: a systematic review

Background

The purpose of this study was to critically review the existing literature on the effects of active video games (AVGs) on physical activity in overweight and obese college students to determine whether AVGs can promote and achieve recommended levels of physical activity. The results should provide constructive input for future research.

Methods

A total of five international databases including PubMed, SCOPUS, Web of Science, CINAHL Plus, and EBSCOhost were searched with keywords related to "active video games," "physical activity," and "obese college students" from July 2022. A systematic review was conducted using the PRISMA guidelines and randomised controlled trial (RCT) studies that met the inclusion criteria were included. Furthermore, the quality assessment of the studies was measured using the PEDro scale.

Results

One thousand and twenty-three articles were retrieved, of which eight randomised controlled trial studies met the inclusion criteria. AVGs can reduce sedentary behaviour and positively affect physical activity, time spent on moderate-to-vigorous physical activity (MVPA), positive psychological factors, and game attendance rate. Combining AVGs with other assistive devices (such as mini-trampolines and stationary bikes) can enhance the effects of AVGs and provide greater physiological stimulation. Different types of AVGs and game modes can achieve different emotional responses, physiological stimulation, and physical activity levels.

Conclusion

The research findings prove that AVGs can be a viable intervention to increase physical activity in overweight or obese college students, ultimately reaching the recommended physical activity level(PAL). Physical activity can be further increased by incorporating assistive devices or using features supported by self-determination theory (SDT). As a new modality, AVGs could be a potential alternative to traditional physical activity.Systematic Review Registration:https://www.crd.york.ac.uk/prospero, identifier: CRD42022363993.

Biases towards different patients groups. How do they differ during medical education?

OBJECTIVE

This cross-sectional study was a first to attempt to assess how biases towards age, gender and sexual orientation differ during the years of undergraduate medical education.

METHODS

600 medical students from the first, third and sixth year of study participated in the study. Three questionnaires were used: The Ambivalent Sexism Inventory scale (ASI), the Fraboni Scale of Ageism (FSA) and the Homophobia scale (HSc).

RESULTS

Results showed statistical significant differences between the three groups in the total scores of ageism and homophobia. Students in the last year of studies reported more ageist and more homophobic biases than students in the first year of their studies.

CONCLUSIONS

Our results demonstrate a need for education to reduce/address/mitigate bias in medical students. Τhe finding that biases increase in students who are farther along in their education needs further investigation. This warrants particular attention to determine if this is a change due to the medical education process itself.

PRACTICE IMPLICATIONS

Medical education should teach students about diversity and acceptability with updated curriculums and designed interventions.

Explicit and implicit weight bias among health care students: a cross-sectional study of 39 Australian universities

Background

Weight bias exhibited by health care students may continue into their future practice, compromising the provision of care that people living with overweight or obesity receive. This highlights the need to comprehensively examine the extent to which weight bias is present among health care students and the factors that may be associated with students' weight bias.

Methods

In this cross-sectional study, Australian university students enrolled in health care courses were invited via social media advertisements, snowball and convenience sampling, and by making direct contact with universities to complete an online survey. Students provided demographic information including discipline of study, perceived weight status, and state of residence. Students then completed several measures which assessed their explicit and implicit weight bias, and empathy. Descriptive statistics established the presence of explicit and implicit weight bias, and ANCOVAs, ANOVA, and multiple regression analyses were conducted to examine the potential factors associated with students' exhibited weight bias.

Findings

Between March 08, 2022, and March 15, 2022, 900 eligible health care students attending 39 Australian universities participated in the study. Students reported varying levels of explicit and implicit weight bias, with minimal differences between disciplines on most outcome measures. Students who identified as men (vs. women) exhibited higher of both explicit and implicit bias (Beliefs About Obese Persons (BAOP): p = 0.0002, Antifat Attitudes Questionnaire (AFA)-Dislike: p = 0.019, AFA Willpower p < 0.0001, Empathy for Obese Patients: p = 0.0011, Implicit Association Test: p = 0.022), and students who displayed greater (vs. less) empathic concern exhibited lower levels of explicit bias (BAOP, AFA Dislike and Willpower, and Empathy for Obese Patients: p < 0.0001). Having witnessed the enactment of weight stigma sporadically (vs. regularly) by role models was associated with greater attribution of the causes of obesity to willpower (a few times a month vs. daily: p = 0.020, a few times a year vs. daily: p = 0.022), and less time spent with people living with overweight or obesity outside of study was associated with more dislike (a few times a month vs. daily: p = 0.0048, once a month vs. daily: p = 0.0002) and less fear of fat (once a month vs. daily: p = 0.036, and once a month vs. a few times a week: p = 0.0028).

Interpretation

Results demonstrate the presence of both explicit and implicit weight bias among Australian health care students. Several characteristics and experiences of students were associated with their weight bias. Validity of the exhibited weight bias should be established in practical interactions with people living with overweight or obesity and novel interventions should be developed to ameliorate weight bias.

Funding

Research Training Program (RTP) Scholarship, Australian Government, Department of Education.

The Effect of a Multifaceted Intervention Including Classroom Education and Bariatric Weight Suit Use on Medical Students' Attitudes toward Patients with Obesity

INTRODUCTION

Weight bias refers to negative attitudes toward individuals because of their weight. Evidence-based strategies to successfully reduce weight bias in medical students are lacking. The purpose of this study was to investigate the impact of a multifaceted intervention on medical students' attitudes toward patients with obesity.

METHODS

Third and fourth year medical students (n = 79), who enrolled in an 8-week graduate course focusing on the various epidemiologic, physiological, and clinical aspects of obesity, including a gamification task with bariatric weight suits (BWSs), were asked to complete the Nutrition, Exercise and Weight Management (NEW) Attitudes Scale questionnaire pre- and post-course. The inclusion period was between September 2018 and June 2021 and covered 4 consecutive groups of students.

RESULTS

The overall NEW Attitudes Scale scores did not change significantly pre- versus post-intervention (pre-course: 19.59, post-course: 24.21, p value = 0.24). However, the subgroup of 4th year medical students showed a significant improvement in their attitudes (pre-course: 16.4, post-course: 26.16, p value = 0.02). The Thurstone rating of 9 out of 31 individual survey items changed significantly from pre- to post-course with a moderate strength (Cramer's V >0.2), including 5 items showing weight bias reduction. The disagreement with the statement "overweight/obese individuals lack willpower" increased from 37 to 68%.

CONCLUSION

These findings suggest that in medical students with a low level of weight bias at baseline, a semester course on obesity combined with BWS use affects only a limited number of items of the NEW Attitudes Scale questionnaire. The sensitization of medical students to weight stigma has the potential to improve quality of healthcare for patients with obesity.

Impact of bariatric and metabolic surgery education program on the knowledge and attitude of medical students

Objectives

Bariatric and metabolic surgery (BMS) is the most effective treatment method of morbid obesity. Optimum education of medical students regarding BMS is important for proper assessment of morbidly obese patients in the future.

Material and Methods

Medical students from five and six years were determined as the targeted study population. A survey including 17 questions was applied through a web-based survey platform. Students who replied the survey were classified into two groups: distinct bariatric and metabolic surgery education program (BMSEP) (+) and (-). The answers of two groups were compared using Chi-square test.

Results

In total, 845 students replied the survey. Surgery referral rates were higher (33.4% vs. 26.5%, p <0.05), referring to alternative treatment methods were low (4.9% vs. 11.9%, p <0.05), the answer rate of "absolutely agree" was higher and "have no idea" was lower in questions regarding the indications of BMS for the sample patient with body mass index (BMI)> 40 kg/m² and the sample patient with BMI between 35-40 kg/m² in the BMSEP (+) group (p <0.05). However, the two groups were comparable for the answers given for the sample patient of BMI 30-35 kg/m² with uncontrolled diabetes. The rate of first-degree relative referral to BMS when indicated was higher in the BMSEP (+) group. Effectiveness of surgery, cost and risk perception were comparable between the two groups.

Conclusion

This study showed that medical students who have a distinct BMSEP in their medical school have better level of knowledge and comparable risk perception regarding BMS. Structured education programs in BMS may directly improve knowledge, perception, and attitude of medical students and indirectly increase the role of primary care physicians in patient referral to BMS and long-term follow-up.

PREJUDICES OF PRIMARY SCHOOL TEACHERS AGAINST OBESITY AND RELATED FACTORS

Amaç: Günümüzün önemli bir sağlık sorunu olan çocukluk çağı obezitesiyle mücadalede etkin rol oynayabilecek öğretmenlerin obezite önyargı durumlarının ortaya konulması önemlidir. Bu çalışmada Kırşehir il merkezindeki ilkokul öğretmenlerinin obezite önyargı durumları ve obez öğrencilere karşı yaklaşımlarının belirlenmesi amaçlandı. Gereç ve Yöntemler: Tanımlayıcı kesitsel tipteki bu çalışmaya 200 ilkokul öğretmeni dahil edildi. Veriler anket formu aracılığıyla yüz yüze toplandı. Öğretmenlerin obezite önyargı durumları “GAMS-27 Obezite Önyargı Ölçeği” (OÖÖ) kullanılarak değerlendirildi. OÖÖ ölçeğinden alınan puanın artması obezlere karşı önyargının artması anlamına gelmektedir. Tanımlayıcı bulgular sayı ve yüzdelerle ifade edildi. Karşılaştırmalı analizlerde Pearson ki-kare, t testi ve tek yönlü ANOVA testi, post hoc analizlerde Duncan testi kullanıldı. p

Empathy as a Factor Conditioning Attitudes towards the Elderly among Physiotherapists-Results from Poland

Attitudes of healthcare workers towards the elderly significantly affect the quality of care dedicated to this group of patients. The purpose of this study was to assess the approach of Polish physiotherapists to the elderly and to analyze the factors influencing these attitudes. The study was based on a cross-sectional Internet-based survey that was conducted in the period from May to September 2021. It was completed by 252 subjects: 189 women and 63 men. The study was based on the involvement of physiotherapists with the right to practice their profession in accordance with the law in force in Poland. The tools used in the study were The Kogan Attitudes towards the Elderly (KAOP) score and The Jefferson Empathy Scale (JSE). To model the KOAP score as a function of the predictors, Bayesian linear regression was used. The average KOAP score in the sample was M (SD) = 100.7 (17.46), with the central 50% of the observations ranging from 81 to 113 points. We observed one statistically credible relationship: relevance of contacts with elderly people was positively and moderately related to KOAP. Additionally, we observed that the JSE scale was positively, but very weakly, associated with KOAP. Empathy and own experience of health care providers may protect against negative attitudes towards the elderly, meaning empathy in healthcare professionals is crucial.

The Effect of an Education Module to Reduce Weight Bias among Medical Centers Employees: A Randomized Controlled Trial

INTRODUCTION

Weight bias, stigma, and discrimination are common among healthcare professionals. We aimed to evaluate whether an online education module affects weight bias and knowledge about obesity in a private medical center setting.

METHODS

An open-label randomized controlled trial was conducted among all employees of a chain of private medical centers in Israel (n = 3,290). Employees who confirmed their consent to participate in the study were randomized into intervention or control (i.e., "no intervention") arms. The study intervention was an online 15-min educational module that included obesity, weight bias, stigma, and discrimination information. Questionnaires on Anti-Fat Attitudes (AFA), fat-phobia scale (F-scale), and beliefs about the causes of obesity were answered at baseline (i.e., right before the intervention), 7 days, and 30 days post-intervention.

RESULTS

A total of 506, 230, and 145 employees responded to the baseline, 7-day, and 30-day post-intervention questionnaires, respectively. Mean participant age was 43.3 ± 11.6 years, 84.6% were women, and 67.4% held an academic degree. Mean F-scale scores and percentage of participants with above-average fat-phobic attitudes (≥3.6) significantly decreased only within the intervention group over time (p ≤ 0.042). However, no significant differences between groups over time were observed for AFA scores or factors beliefs to cause obesity.

CONCLUSIONS

A single exposure to an online education module on weight bias and knowledge about obesity may confer only a modest short-term improvement in medical center employees' fat-phobic attitudes toward people with obesity. Future studies should examine if reexposure to such intervention could impact weight bias, stigma, and discrimination among medical center staff in the long-term.

Perception of obesity and overweight among adults living in suburban Nepal: a qualitative study

OBJECTIVE

To explore the perception of obesity and overweight among Nepalese adults living in a suburban community.

DESIGN

A qualitative study composed of focus group discussion (FGD) and in-depth interview (IDI).

SETTING

Community and healthcare facilities in Dhulikhel, Nepal.

PARTICIPANTS

Four FGDs were conducted with community members (n=22) and four IDIs were conducted with healthcare providers (HCPs).

RESULTS

Obesity is a rising problem in this suburban community. Participants had inadequate knowledge regarding the consequences of obesity, and they perceived overweight as normal, healthy and attractive. The participants above 40 years of age did not perceive themselves to be overweight or obese. Despite participants' awareness of the importance of diet control and exercise to prevent obesity, these were not translated into practice.

CONCLUSIONS

This study provided insight into perceptions of obesity in a suburban Dhulikhel community through both community members' and HCPs' perspective. Misconceptions and inadequate knowledge of obesity among people in this community indicate the need for health education and intervention programme to increase health awareness and preventive practices.

Obesity bias and stigma, attitudes and beliefs among entry-level physiotherapy students in the Republic of Ireland: a cross sectional study

OBJECTIVE

To explore entry-level physiotherapy students' attitudes and beliefs relating to weight bias and stigmatisation in healthcare.

DESIGN

Cross sectional survey of physiotherapy students.

METHODS

All final year physiotherapy students (n = 215) enrolled in entry-level physiotherapy programmes in the Republic of Ireland were invited to participate. Each received a questionnaire, consisting of 72 questions, within four key sections. Descriptive statistics and frequencies were used to analyse the data.

RESULTS

A response rate of 83% (179/215) was achieved. Whilst physiotherapy students, overall, had a positive attitude towards people with obesity, 29% had a negative attitude towards people with obesity, 24% had a negative attitude towards managing this population and most (74%) believed obesity was caused by behavioural and individual factors. Over one third of students (35%) reported that they would not be confident in managing patients with obesity and more than half (54%) felt treating patients with obesity was not worthwhile.

CONCLUSION

This study provides preliminary findings to suggest that weight stigma-reduction efforts are warranted for physiotherapy students. Helping students to understand that obesity is a complex, chronic condition with multiple aspects requiring a multi-faceted approach to its management might be the first step towards dispelling these negative attitudes towards patients living with obesity. Inclusion of a formal obesity curriculum should perhaps now be part of the contemporary physiotherapy students' education.

More than a "monstrous obesity"! Time to overcome the "anti-fat" bias

A 54-years-old woman complained of unintentional important body weight gain associated with abdominal bloating. For this reason, she had consulted many different diet and nutritional professionals, general practitioners and a gastroenterology specialist, but no one went beyond a simple diagnosis of "monstrous obesity". At our hospital division, based on physical examination, a computed tomography (CT) of the abdomen and pelvis was performed. It showed a voluminous intraperitoneal mass occupying the most part of the abdomen. The patient underwent laparotomy with resection of the abdomino-pelvic mass, originating from the left ovary, measuring 60 x 45 cm and weighing 46 kg. Histopathology examination revealed a tumor composed of three different areas, including a well-differentiated adenocarcinoma of intestinal-type. It is emblematic of a grotesque misdiagnosis generated by a non-comprehensive patient assessment and consequently by a too quick judgement related to the "anti-fat bias".

Influence of Body Mass Index and Gender on Stigmatization of Obesity

BACKGROUND

Stigmatization and discrimination of people with obesity due to their weight are a common problem that may lead to additional weight gain. This study evaluated the influence of different parameters on the stigmatization of obesity.

MATERIAL AND METHODS

Participants of six groups (general population, patients with obesity, medical students, physicians, nurses in training and nurses; n = 490) answered the short-form fat phobia scale (FPS) between August 2016 and July 2017. The influence of body mass index (BMI), gender and other factors on total scores and single adjective pairs was analyzed.

RESULTS

A total of 490 participants were evaluated. The total mean FPS rating was 3.5 ± 0.6. FPS was significantly lower (more positive) in participants with obesity (3.2 ± 0.7) compared with participants without obesity (3.5 ± 0.5, p < 0.001). Individuals with obesity and diabetes rated the FPS significantly lower (more positive), whereas age and gender did not have a significant influence. Participants with obesity linked obesity more often with good self-control (p < 0.001), being shapely (p = 0.002), industrious (p < 0.001), attractive (p < 0.001), active (p < 0.001), self-sacrificing (p < 0.001) and having more willpower (p < 0.001) than the participants without obesity. Females rated more positive in shapely versus shapeless (p = 0.038) and attractive versus non-attractive (p < 0.001) than males.

CONCLUSIONS

The present study shows that stigmatization of obesity is present in medical professionals as well as the general population. People affected by obesity characterized other people with obesity more positively (e.g. attractive or active), whereas people without obesity linked negative characteristics with obesity. Gender had an influence only on single items of FPS but did not affect overall stigmatization of obesity.

Attitudes and treatment practice of general practitioners towards patients with obesity in primary care

Background

Obesity is one of the most common and relevant health problems in need of urgent action in Germany. General practitioners (GPs) are the initial contact and thus one of the most important starting points for the successful treatment of overweight and obesity. The aim of the study was to assess the treatment practice and attitudes towards patients with obesity in primary health care in Germany.

Methods

Analyses were based on baseline data of the INTERACT trial of 47 GPs in central Germany. Stigmatizing attitudes were identified using the Fat Phobia Scale (FPS). In addition, questionnaires including sociodemographic information, attribution of causes of obesity, referral behavior and clinical activities were completed. Statistical investigations include descriptive analysis, principal component analysis, inference statistics and linear regression models.

Results

GPs rated the quality of medical care for patients with obesity in Germany as below average. The FPS score revealed a value of 3.70, showing that GPs’ attitudes towards patients with obesity are stigmatizing. Younger GP age, male gender and a lower number of referrals to specialists were associated with higher levels of stigmatizing attitudes.

Conclusion

Weight-related stigmatization has an impact on medical treatment. Obesity management guides would help to increase knowledge and reduce weight-related stigmatization in primary care, thereby improving medical care for obese and overweight patients.

Living with obesity - existential experiences

Aims and objectives: The aim was to gain in-depth understanding about individuals’ existential experiences of living with obesity.

Background: People living with obesity face great vulnerability and existential challenges. The different treatments offered do not seem to meet the individual needs of persons with obesity. A deeper understanding of existential experiences from an individual perspective is needed to individualize treatment.

Design: An exploratory phenomenological–hermeneutical design was used to gain a greater understanding of the existential experiences involved in living with obesity.

Methods: The participants represented a convenient sample. 18 qualitative interviews were conducted and subjected to phenomenological–hermeneutical analysis.

Results: Four themes emerged: shaped by childhood; captured by food; depressed by the culture; and judged by oneself.

Conclusions: The burden of being obese can be experienced as being objectified and alienated as a human being. We need to turn towards a life-world perspective, seeing each human being as a living body to overcome objectification and alienation, and then move them towards becoming subjects in their own lives, through giving space for self-love. Health care workers need to assist persons living with obesity to reduce objectification and alienation. It is important to develop intervention that has an individual, holistic approach.

Living With Obesity: Expressions of Longing

Those who are obese experience complex moral distress. The norm in Western societies is to be slim, and people living with obesity experience challenges under the gaze of society. They feel great vulnerability and the available treatments seldom meet individual needs. New concepts of embodiment need to be developed to include phenomenological investigations. There is limited knowledge about longing among those suffering from obesity. A deeper understanding of longing from an individual perspective is required to improve treatment. The aim of this study was to gain an in-depth understanding of the experiences of longing by those suffering from obesity. The research was approved by the Norwegian Regional Committees for Medical and Health Research Ethics. An explorative phenomenological–hermeneutical design was used. Qualitative interviews were conducted with 18 participants, all with body mass indexes in the range of 30 to 45, which were then analyzed using a phenomenological–hermeneutical approach. Three main dimensions of longing were revealed: longing for normality, longing for what was lost, and longing for simplicity in life. The health service needs to understand better the longings of obese individuals to help them live their lives in greater freedom, based on their own longings and self-care. Focusing on longing may reveal a person’s true desires, and the longing may be a form of resistance to the disciplination of society.

Is there prejudice against obese persons among health professionals? A sample of student nurses and registered nurses

PURPOSE

The aim of this study was to assess whether there is prejudice toward obese persons among student nurses and registered nurses.

DESIGN AND METHOD

A total of 379 participants were included (190 student nurses, 189 registered nurses). The Fat Phobia Scale and Belief About Obese Persons Scale were used to determine the prejudice.

FINDINGS

Registered nurses were found to have more negative prejudices toward obese persons than those of student nurses. These prejudices were determined to be influenced by the nurses' body mass index and having an obese person in the family.

PRACTICAL IMPLICATIONS

Both groups had negative prejudices toward obese persons, there was a higher level of prejudice among the registered nurses. These prejudices can have a negative impact on healthcare practices.

Prejudice against obesity in university students studying in health-related departments

PURPOSE

This study was conducted to determine the degree of obesity prejudice exhibited and felt by students attending health-related departments.

DESIGN AND METHOD

The sample included 729 students studying in health-related departments at a university in Turkey who volunteered to take part in the study.

FINDINGS

The average Obesity Prejudice Scale (OPS) score of the students was 75.54±10.43, thus indicating that they tend toward prejudice.

PRACTICAL IMPLICATIONS

According to the results of the study, university students who will be future nurses and other healthcare professionals, tend toward obesity prejudice, negatively impacting health care.

Video Teaching Leads to Improved Attitudes Towards Obesity-a Randomized Study with 949 Participants

BACKGROUND

Obesity is a rising social and economic burden. Patients with obesity often suffer from stigmatization and discrimination. Underrecognition of obesity as a disease could be a contributing factor. The present study aimed to compare attitudes towards obesity with other chronic diseases and to evaluate the recognition of need of professional treatment.

METHODS

Nine hundred and forty-nine participants (subgroups: general population, patients with obesity, nurses in training, nurses, medical students, physicians) were randomized to video teaching on obesity and control. Questionnaires on the burden and influence of obesity on daily life compared to other chronic diseases and the fat phobia scale (FPS) were answered.

RESULTS

Burden of obesity was rated low (4.2 ± 1.3; rank 9 of 11) compared to other diseases. Bowel cancer (5.5 ± 0.9) had the highest and caries the lowest (2.7 ± 1.4) estimated impact. Females (p = 0.011) and older people (p < 0.001) rated burden of obesity high whereas general population (p < 0.001) and control (p < 0.001) rated it low. Females (p = 0.001) and people with higher BMI (p = 0.004) rated the influence of obesity on daily life high; the general population (p < 0.001; reference physicians) and the control group (p < 0.001) rated it low. FPS was lowest in patients with obesity (3.2 ± 0.7) and highest in the general population (3.6 ± 0.4) and medical students (3.6 ± 0.5; p < 0.001; compared to physicians).

CONCLUSIONS

Obesity is underestimated as a disease compared to other chronic diseases and attitudes towards obesity are rather negative in comparison. Video teaching showed positive effects so a focus in medical education and public campaigns should aim to improve prevention and treatment of obesity.

Associations between medical students' beliefs about obesity and clinical counseling proficiency

Background

Despite evidence that biological and genetic factors contribute strongly to obesity, many healthcare providers still attribute obesity more to controllable behavioral issues rather than factors outside a person’s control. We evaluated whether medical school students’ beliefs about obesity correlate with ability to effectively counsel patients with obesity.

Methods

Clerkship-year medical students at NYU School of Medicine completed an Objective Structured Clinical Experience (OSCE) that tests ability to effectively counsel standardized actor-patients with obesity. We surveyed these students to evaluate their beliefs about the causes of obesity and their attitudes towards people with obesity. We analyzed correlations between student beliefs, negative obesity attitudes, and OSCE performance.

Results

The response rate was 60.7% (n = 71). When asked to rate the importance of individual factors, students rated controllable factors such as unhealthy diet, physical inactivity, and overeating as more important than genetics or biological factors (p < 0.01). Believing obesity is caused by uncontrollable factors was negatively correlated with obesity bias (r = − 0.447; p < 0.0001). Believing that obesity is caused by factors within a person’s control was negatively correlated with counseling skills (r = − 0.235; p < 0.05).

Conclusions

Attribution of obesity to external factors correlated with greater ability to counsel patients with obesity, suggesting that educating providers on the biological causes of obesity could help reduce bias and improve provider care.

[Transcultural adaptation of the Antifat Attitudes Test to Brazilian Portuguese]

Obese individuals are often blamed for their own condition and the targets of discrimination and prejudice. The scope of this study is to describe the cross-cultural adaptation to Brazilian Portuguese and the validation of the Antifat Attitudes Test - specifically developed for evaluation of negative attitudes toward the obese individual. The scale has 34 statements distributed in three subscales - Social/Character Disparagement (15 items), Physical/Romantic Unattractiveness (10 items) and Weight Control/Blame (9 items). The method involved the translation of the scale; evaluation of the conceptual, operational and item equivalence; evaluation of the semantic equivalence using the paired t test, the Pearson correlation coefficient and the intraclass correlation coefficient (ICC); internal consistency evaluation (Cronbach's alpha) and test-retest reliability (ICC) and Confirmatory Factor Analysis - after application in 340 college students in the area of health. The results showed good global internal consistency and reliability (α 0.85; CCI 0.83), and factor analysis showed that the original subscales can be kept in the adaptation, and therefore the scale adapted to the Brazilian-Portuguese version is valid and useful in studies to explore negative attitudes toward obese individuals.

Obesity Education in Medical School Curricula in Korea

Obesity is one of the three most common diseases, affecting about one-third of adults. Obesity also increases vulnerability to metabolic disorders, psychological disorders, and various cancers and decreases quality of life. Therefore, obesity must be adequately addressed in medical school. Here, I will review how obesity education is implemented in medical school curricula in Korea. Many studies have shown that students who are well educated about obesity through various educational methods reduce their prejudice toward obese patients. The Korean Society for the Study of Obesity is an interdisciplinary academy, including experts from fields such as general research, clinical practice, nutrition, nursing, exercise, and rehabilitation. They aim to identify the core competencies of obesity education necessary for medical students, develop curricula of obesity education, and present examples of lectures and discussions. In the future, health professionals who receive such education will be able to take better care of obese patients without bias.

The attitudes of student nurses towards obese patients: A questionnaire study exploring the association between perceived causal factors and advice giving

BACKGROUND

Nurses acting in primary care roles are central in addressing obesity as a public health priority. Nurses with a lower Body Mass Index have been shown to have negative attitudes towards obesity. Additionally, where the patient is perceived as being responsible for their excess weight, a negative attitude may also be held. The extent to which negative attitudes may influence the advice provided by nurses to obese patients is unknown.

OBJECTIVES

The present paper sought to examine whether the level of advice offered to obese patients by student nurses is associated with (i) the perceived causal factors of obesity, (ii) attitudes towards obesity and (iii) body mass index of the nurse.

METHOD

Participants were 92 student nurses from a university in the Midlands, UK. Participants received one of four patient vignettes; three were affected by obesity, with reference to either a behavioural, social, or medical cause; and the fourth was normal weight. Student nurses elected advice they would offer from five staged options (from no active involvement in advising the patient, through to discussing dietary advice). Attitudes towards obesity and social desirability were measured using validated questionnaires.

RESULTS

No association was found between the level of advice offered and either the causal factor of obesity, the student nurses' attitude towards obesity, or the nurses' Body Mass Index. Most students endorsed the highest level of advice-a patient centred discussion.

CONCLUSION

Findings show that advice giving by student nurses was not associated with perceived cause of obesity, or attitude, but is in line with the current Nursing and Midwifery Council (2015) recommendations. That is, most students endorsed a patient centred discussion. This suggests that professional training guidelines for the non-judgemental treatment of obese patients are not only being recognised, but implemented.

Obese patients and radiography literature: what do we know about a big issue?

Obesity is a global health issue with obese patients requiring specialised diagnosis, treatment and care through the health service. The practical and social difficulties associated with medical imaging of obese patients are an increasingly common problem and it is currently unknown how student and qualified radiographers perceive and respond to these challenges. By better understanding challenges presented in providing quality imaging and care of imaging obese patients, education for both qualified and student radiographers can be enhanced. Radiographers are heavily reliant on visual and tactile senses to locate the position of anatomical structures for diagnostic imaging and determine radiation exposure through a delicate consideration of dose, image quality and anatomical attenuation. However, obese patients require modifications to routine radiographic practice in terms of movement/assisted positioning, equipment capabilities to take increased weight or coverage. These patients may also be subject to compromised radiological diagnosis through poor visualisation of structures. In this paper, the professional and educational literature was narratively reviewed to assess gaps in the evidence base related to the skill and care knowledge for obese patients. Literature was sourced relating to discrete radiographic considerations such as the technical factors of imaging obese patients, exposure and the impact of obesity on imaging departments’ service provisions. The recent literature (post-2000 to coincide with the sharp increase in global obesity) on the perceptions of health professionals and student health practitioners has also been explored because there are no specific radiographer studies to report. By understanding the research in similar fields, we may identify what common attitudes qualified and student radiographer's hold and what challenges, technical and care related, can be prepared for.

Measuring negative attitudes towards overweight and obesity in the German population - psychometric properties and reference values for the German short version of the Fat Phobia Scale (FPS)

Objective

Obesity is one of the leading public health problems worldwide. Obese individuals are often stigmatized and the psychosocial consequences of overweight and obesity are the subject of current research. To detect stigmatizing attitudes towards obese people, the Fat Phobia Scale (FPS) was developed in the USA in the early nineties. In addition, the 14-item short form of the FPS was constructed. The FPS belongs to the most commonly used instruments for measuring negative attitudes towards obese people because of its good psychometric properties. For the recently developed German short form of the FPS, however, the comprehensive investigation of the psychometric properties and the determination of reference values are still pending. Thus, the main objectives of this study were the evaluation of the psychometric quality of the scale as well as the calculation of reference values.

Methods

The study was based on a representative survey in the German general population. A sample of 1,657 subjects (18–94 years) was assessed via structured telephone interviews including the 14-item German version of the FPS. Descriptive statistics and inference-statistical analyses were conducted. Reference values in terms of percentage ranks were calculated.

Results

Substantial evidence for the reliability and validity of the German short version of the FPS was found. This study, for the first time in Germany, provides age-specific reference values for the German short form of the FPS allowing the interpretation of individual test scores.

Conclusion

Facing the far-reaching consequences of experienced stigmatization of obese individuals, these study results provide an important basis for further studies aiming at the investigation of negative attitudes towards overweight and obesity.