Background

Weight bias is pervasive among healthcare providers/trainees. Positive interpersonal contact can reduce weight biases. The objective of this study was to test a model of the relationships among quantity and favorability of contact, implicit and explicit weight bias, perceived skill in weight loss counseling, and demographics among medical trainees longitudinally.

Methods

A cohort of 2370 trainees completed web-based surveys at years 1 and 4 of medical school and again after their 2nd year of residency. Structural equation modeling was used to test the fit of a hypothesized model of contact, weight bias, and perceived skill, over the course of medical training.

Results

Model fit was adequate; χ² (70, N = 1432) = 614.99, p <.001, CFI = 0.93, SRMR = 0.08; Figure). At year 1, quantity and favorability of interactions were inversely correlated with explicit weight bias; each year positively predicted subsequent year implicit and explicit bias levels. Favorability of contact mediated the change in explicit bias over time, and mediated change in implicit bias only from year 1-4. BMI was related to explicit weight at baseline but did not moderate the relationship between contact and weight bias over time. Similarly, race and gender did not moderate these relationships.

Conclusions

Results support a relationship between quantity and favorability of contact, implicit and explicit weight bias, perceived skill in weight loss counseling, and demographics among medical trainees longitudinally. Increasing frequent, positive contact with obese individuals may result in less weight bias for medical providers over time.