Weight bias in healthcare is well documented. People living in larger bodies frequently report feeling judged, blamed, or dismissed in clinical settings. Some delay or avoid healthcare altogether because of previous negative experiences.
If this is happening in practice, an important question follows: when does weight bias begin?
Evidence suggests it can emerge during training. In our previous research, we found that healthcare students across Australia endorse varying levels of explicit weight bias, conscious beliefs and attitudes such as attributing weight primarily to personal responsibility. If these beliefs persist into professional practice, they may influence patient care.
We therefore asked a practical question: can a brief, scalable intervention shift these attitudes?
Designing a Brief Intervention
We conducted a randomised controlled trial with healthcare students from 14 Australian universities across 15 disciplines. Participants were randomly assigned to watch one of three short videos:
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An empathy-focused video, featuring a person living with obesity sharing experiences of weight stigma in healthcare.
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A science-focused video, explaining the multifactorial causes of obesity, including genetics, physiology, hormones, medication effects, and socioeconomic influences.
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A control video unrelated to weight.
Each video was approximately 10 minutes long. Students completed measures of explicit weight bias, empathy, and clinical confidence at baseline, immediately after viewing, and two weeks later.
The rationale was straightforward. University curricula are crowded, and brief tools are easier to implement at scale. If a short intervention could meaningfully reduce weight bias, it could be integrated widely into healthcare training programs.
What We Found
The findings were nuanced.
The empathy-focused video was associated with increased confidence in interacting clinically with patients living with obesity, although this effect was not sustained at follow-up.
The science-focused video was associated with improvements in empathy and greater understanding of the socioeconomic contributors to obesity. Notably, the increase in empathy was maintained at two-week follow-up.
However, across most explicit weight bias measures, changes were limited.
In other words, brief videos may influence specific attitudes, particularly empathy and clinical confidence, but they are unlikely to meaningfully reduce explicit weight bias when delivered as standalone interventions.
What Resonated with Students
We also asked participants to list the three key take-home messages from the video they viewed.
Students who watched the lived-experience video most often highlighted practical strategies: asking permission before discussing weight, avoiding assumptions, and using respectful language.
Students who watched the science-focused video frequently emphasised that obesity is complex and not simply a matter of willpower. Many noted the roles of genetics, environment, and socioeconomic factors, and acknowledged the harmful impact of weight stigma in healthcare.
Even where bias scores did not shift dramatically, students demonstrated cognitive reframing, recognising complexity and identifying ways to provide more equitable care.
Challenges and Broader Implications
Like many online intervention studies, attrition was substantial. Although 252 students initially enrolled, 103 completed all required measures for the primary analysis. This reflects the realities of conducting research with busy student populations. More fundamentally, weight bias is socially reinforced and often normalised. Students may have internalised beliefs about weight long before entering healthcare training.
Our findings align with broader evidence suggesting that brief interventions tend to produce small or short-lived effects. Sustainable change may require repeated exposure, active learning, and integration across curricula rather than standalone modules.
This study suggests that both lived experience narratives and science-based education have value. Narratives may enhance clinical confidence. Education about biological and socioeconomic contributors may foster empathy and reduce blame.
However, meaningful reductions in explicit weight bias likely require structural approaches embedded within healthcare education.
Healthcare students today are the clinicians of tomorrow. The beliefs formed during training can shape clinical communication, decision-making, and patient trust. If we aim to create healthcare environments where all patients are treated with dignity and respect, weight bias reduction must begin early, and be reinforced throughout training.
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