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Signalling hostility: The relationship between witnessing weight-based discrimination in medical school and medical student wellbeing

Meadows, Angela and Barreto, Manuela and Dovidio, John F and Burke, Sara E and Wittlin, Natalie M and Herrin, Jeph and van Ryn, Michelle and Phelan, Sean M (2021) 'Signalling hostility: The relationship between witnessing weight-based discrimination in medical school and medical student wellbeing.' Journal of Applied Social Psychology. ISSN 0021-9029

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Abstract

Environments that are hostile to one or more marginalised groups are known to have a negative effect on the mental health and wellbeing of both targets and observers. Anti-fat attitudes have been well documented in medical education, including the use of derogatory humour and discriminatory treatment towards higher-weight patients. However, to date, it is not known what effect observing weight stigma and discrimination during medical school has on medical students’ psychological health and wellbeing, sense of belonging, and medical school burnout. The present study surveyed a total of 3,994 students enrolled across 49 US medical schools at the start of their first year and at the end of their fourth year. Participants reported the frequency with which they had observed stigmatising and discriminatory behaviours targeted at both higher-weight patients and higher-weight students during their four years of medical school. Observed weight stigma was prevalent, and was associated with worse psychological and general health, reduced medical school belonging and increased medical school burnout. The indirect effects of observed weight stigma on medical school burnout, via belonging, psychological health, and general health, were statistically significant in the sample as a whole, but were more pronounced in higher-weight students. This effect may be explained, in part, by the relationship between observed stigma and medical school belonging. Higher levels of observed stigma were associated with reduced feelings of belonging in higher-weight but not normative-weight students. Top-down institutional culture change is needed to rectify this situation, which is detrimental to both students and patients.

Item Type: Article
Uncontrolled Keywords: weight stigma; anti-fat attitudes; medical education; microaggressions; observed discrimination; indirect discrimination; organisational climate
Divisions: Faculty of Science and Health
Faculty of Science and Health > Psychology, Department of
SWORD Depositor: Elements
Depositing User: Elements
Date Deposited: 16 Dec 2021 17:12
Last Modified: 06 Jan 2022 14:33
URI: http://repository.essex.ac.uk/id/eprint/31715

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