Weight bias and preparedness to treat higher-weight patients: Understanding the role of motivation to respond without weight-based prejudice among resident physicians

Abstract

Weight stigma is widely recognized as a significant concern in healthcare. Studies indicate that as medical trainees advance through their training, their levels of weight bias may intensify. Such prejudices can lead to inferior care for higher-weight patients, underscoring the urgency for research that identifies factors that are protective against the development of weight bias. Prior findings have shown that the motivation to respond without prejudice is a key determinant of explicit bias across various contexts, yet its role concerning weight bias remains underexplored. In a one-year longitudinal study of U.S. resident physicians (N = 3,507), we examined the associations between participants' internal motivation (i.e., based on personal values) and external motivation (i.e., based on social pressures) to respond without weight-based prejudice on self-reported explicit weight bias, self-rated preparedness to treat higher-weight patients, and participation in bias-related training. We found that internal motivation predicted lower weight bias (across three measures) and greater self-rated preparedness to treat higher-weight patients (ps ≤ 0.001), whereas external motivation predicted higher weight bias (ps < 0.001). Participants' internal motivation also predicted their participation in bias-related training during the following year (ps ≤ 0.01). Each of these findings held when controlling for demographic variables and BMI. Participants were young and predominantly white, so further research will be needed to generalize these findings to the broader population of healthcare providers. Taken together, these findings suggest that internal motivation to respond without weight-based prejudice may be a useful target for future bias-reduction intervention efforts.

Keywords: healthcare providers; higher weight; motivation to respond without prejudice; weight bias; weight stigma.