Medical Education

Does Med School Teach Myths or Facts About Obesity?

Here’s a jolt of reality from research at the NYU School of Medicine. Among the students who are ready to go into the clinic for their clerkships, most of them believe that controllable factors are very important causes of obesity. But most of them think that biological and genetic factors are not very important. This lines up with quite a bit of other data that suggests med schools are not teaching the facts about obesity.

Further, this research suggests this missing knowledge is critical for providing competent obesity care. Victoria Fang and colleagues published these findings in BMC Obesity.

Simply Eating Too Much and Moving Too Little

The dominant view of obesity Fang et al found in third year med school students was pretty simple. The students believed people have obesity mainly because of factors under their control. They eat too much of the wrong things. Plus, they’re inactive. Med students discounted the physiologic and genetic basis for obesity.

Not only did the researchers ask these students for their beliefs about obesity, they also tested their ability to provide competent counseling to patients with obesity. For this, the students completed an objective structured clinical experience (OSCE).

False Beliefs Get in the Way

Students who knew that obesity can result from factors beyond an individual’s control had less bias against patients with obesity. So it’s not a big surprise these beliefs had a significant relationship with competence for providing obesity care. Students who thought obesity comes from controllable factors had significantly less skill in the OSCE.

If you think patients are the cause of their own problems, that blame game gets in the way of effective, empathetic care.

Working Toward Higher Standards

Without a doubt, much work remains to be done. Obesity is the most common chronic disease that doctors will see in clinical practice. And it lies at the root of many of the other chronic diseases they will encounter – type 2 diabetes, heart disease, arthritis, liver disease, and a number of cancers, just to name a few. If clinicians don’t understand the biological and environmental basis for obesity, they won’t be able to provide good care.

But change is afoot. The Bipartisan Policy Center worked with representatives of more than 25 diverse organizations to take a first step in 2017. That’s when they unveiled an inventory of provider competencies for all healthcare professionals in obesity care. In addition, the Obesity Medicine Education Collaborative is promoting a higher standard for the full continuum of obesity medicine care. With leadership from the Obesity Medicine Association and the Obesity Society, this group is group is addressing undergraduate, graduate, and fellowship education and training.

It’s a work in progress and medical schools are playing catch up.

Click here for the study by Fang et al.

Medical Education, photograph © Natalie / flickr

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March 19, 2019