Reducing Weight Biased Beliefs in Exercise Science Undergraduate Students: An Educational Workshop for Better Practice

Weight biases are the negative attitudes, beliefs and judgements that might lead to social devaluation and denigration of people perceived to carry excess weight, usually manifested as prejudice, negative stereotyping, and discrimination. Many healthcare providers, including exercise science practitioners, view obesity only because of poor lifestyle decisions, framing obesity as a choice driven by the belief of the controllability of weight. The pathophysiology of obesity is complex. It entails many more factors outside of physical activity levels and nutritional choices, such as social determinants of health, genetics and neuropsychological factors that are often overseen, including weight bias internalization that leads to negative coping strategies and higher rates of mental health disorders. Treatment disparities may arise when patients encounter weight biased providers, further reinforcing internalization of weight bias among overweight and obese individuals. Kinesiology/Exercise Science students report not being sufficiently educated during their undergraduate studies on how to properly care and work with such a special population of patients and clients, yet with almost 2.5 billion overweight adults and 650 million living with obesity, adjustments to current curriculums that include weight bias reduction strategies are required for professional practice to be equitable and unbiased. A three-hour workshop utilizing weight bias reduction strategies was designed using Transformative Learning Theory (TLT) principles and widely used Evidence-Based Health Care education methodologies. It was tested in a group of ten Exercise Science undergraduate students and was compared to a control intervention with the same sample number. The Implicit Association Test (IAT), revealed a preference for thin individuals in the overall without significant differences between both groups (X (5,20) = 5.143, p = .399). At baseline the Fat Phobia Scale (FPS) scores were significantly different, (t(18) = – 1.538, p = .004), the rest of the questionnaires didn’t show significant differences between both groups. A paired samples t test showed statistically significant differences between pre and post scores for the Attitudes Towards Obese People (ATOP) scale, (t(9)=3.26, p = .005), the Anti-fat Attitudes Scale (AFA) questionnaire total scores, (t(9)=5.343, p < .001), AFA Fear of Fat subscale scores, (t(9) = 1.993, p = .039), and AFA Willpower subscale scores, (t(9) = 5.588, p < .001). No significant differences were found in the AFA Dislike subscale score, (t(9) = 1.333, p = .108). Independent samples t-test post intervention scores showed significant difference only for the AFA Willpower, (t(18) = – 3.688, p < .001). The workshop proved effective in reducing beliefs on the controllability of weight measured by the Anti-fat Attitudes Test, consistent with limited existing literature in the same population. Future interventions should aim to include larger sample sizes that are representative of a more diverse student population, implement a crossover design and follow-up on participants over time to assess long lasting changes in the beliefs and application in practice.<p></p>