Development of a brief measure to assess quality of life in obesity. Are Anti-Stigma Films a Useful Strategy for Reducing Weight Bias Among Trainee Healthcare Professionals? Results of a Pilot Randomized Control Trial The mixed impact of medical school on medical students' implicit and explicit weight bias. Weight Bias and Weight Loss Treatment Outcomes in Treatment-Seeking Adults
OBJECTIVE Obesity research ers have a growing interest in measuring the impact of weight and weight reduction on quality of life . The Impact of Weight on  Quality of Life question naire ( IWQOL ) was the first self-report instrument specifically developed to assess the effect of obesity on quality of life . Although the IWQOL has demonstrated excellent psychometric properties , its length ( 74 items ) makes it somewhat cumbersome as an outcome measure in clinical research . This report describes the development of a 31-item version of the IWQOL ( IWQOL-Lite ) . RESEARCH METHODS AND PROCEDURES IWQOLs from 996 obese patients and controls were used to develop the IWQOL-Lite . Psychometric properties of the IWQOL-Lite were examined in a separate cross-validation sample of 991 patients and controls . RESULTS Confirmatory factor analysis provided strong support for the adequacy of the scale structure . The five identified scales of the IWQOL-Lite  ( Physical Function , Self-Esteem , Sexual Life , Public Distress , and Work ) and the total IWQOL-Lite score demonstrated excellent psychometric properties . The reliability of the IWQOL-Lite scales ranged from 0.90 to 0.94 and was 0.96 for the total score . Correlations between the IWQOL-Lite and collateral measures supported the construct validity of the IWQOL-Lite . Changes in  IWQOL-Lite scales over time correlated significantly with changes in weight , supporting its sensitivity to change . Significant differences in IWQOL-Lite scale and total scores were found among groups differing in body mass index , supporting the utility of the IWQOL-Lite across the body mass index spectrum . DISCUSSION The IWQOL-Lite appears to be a psychometrically sound and clinical ly sensitive brief measure of quality of life in obese persons Background : Weight bias is an important clinical issue that the educators of tomorrow 's healthcare professionals can not afford to ignore . This study , therefore , aim ed to pilot a r and omized controlled trial of the effects of educational films design ed to reduce weight stigmatization toward obese patients on trainee dietitians ' and doctors ' attitudes . Methods : A pre-post experimental design with a 6-week follow-up , which consisted of an  intervention group ( n = 22 ) and a  control group ( n = 21 ) , was conducted to assess the efficacy of brief anti-stigma films in reducing weight bias , and to test whether future , larger-scale studies among trainee healthcare professionals are feasible . Results : Participants at baseline  demonstrated weight bias , on both implicit and explicit attitude measures , as well as strong beliefs that obesity is under a person 's control . The intervention films significantly improved explicit attitudes and beliefs toward obese people , and participant evaluation was very positive . The intervention did not significantly improve implicit anti-fat bias . Conclusion : The current study suggests both that it is possible to conduct a substantive trial of the effects of educational films design ed to reduce weight stigma on a larger cohort of trainee healthcare professionals , and that brief educational interventions may be effective in reducing stigmatizing attitudes in this population CONTEXT Health care trainees demonstrate implicit ( automatic , unconscious ) and explicit ( conscious ) bias against people from stigmatised and marginalised social groups , which can negatively influence communication and decision making . Medical schools are well positioned to intervene and reduce bias in new physicians . OBJECTIVES This study was design ed to assess medical school factors that influence change in implicit and explicit bias against individuals from one stigmatised group : people with obesity . METHODS This was a prospect i ve cohort study of medical students enrolled at 49 US medical schools r and omly selected from all US medical schools within the strata of public and private schools and region . Participants were 1795 medical students surveyed at the beginning of their first year and end of their fourth year .  Web-based surveys included measures of weight bias , and medical school experiences and climate . Bias change was compared with changes in bias in the general public over the same period . Linear mixed models were used to assess the impact of curriculum , contact with people with obesity , and faculty role modelling on weight bias change . RESULTS Increased implicit and explicit biases were associated with less positive contact with patients with obesity and more exposure to faculty role modelling of discriminatory behaviour or negative comments about patients with obesity . Increased implicit bias was associated with training in how to deal with difficult patients . On average , implicit weight bias decreased and explicit bias increased during medical school , over a period of time in which implicit weight bias in the general public increased and explicit bias remained stable . CONCLUSIONS Medical schools may reduce students '  weight biases by increasing positive contact between students and patients with obesity , eliminating unprofessional role modelling by faculty members and residents , and altering curricula focused on treating difficult patients Background Few studies have explored the relationship between weight bias and weight loss treatment outcomes . Purpose This investigation examined the relationship between implicit and explicit weight bias and ( a ) program attrition , ( b ) weight loss , ( c ) self-monitoring adherence , ( d ) daily exercise levels and overall caloric expenditure , ( e ) daily caloric intake , and ( f ) daily caloric deficit among overweight/obese treatment-seeking adults . Methods Forty-six overweight/obese adults ( body mass index ≥ 27 kg/m2 ) participating in an 18-week , stepped-care , behavioral weight loss program completed implicit and explicit measures of weight bias .  Participants were instructed to self-monitor and electronically report  daily energy intake , exercise , and energy expenditure . Results Greater weight bias was associated with inconsistent self-monitoring , greater caloric intake , lower energy expenditure and exercise , creation of a smaller caloric deficit , higher program attrition , as well as less weight loss during the self-help phase of the stepped-care treatment . Conclusions Weight bias may interfere with overweight/obese treatment-seeking adults ' ability to achieve optimal health
Most question naires were brief , demonstrated adequate internal consistency , and tapped key cognitive and affective dimensions of weight bias such as stereotypes and blaming .
Background : People living with overweight and obesity often experience weight-based stigmatization .
Investigations of the prevalence and correlates of weight bias and evaluation of weight bias reduction interventions depend upon psychometrically-sound measurement .
Our paper is the first to comprehensively evaluate the psychometric properties , use of people-first language within items , and suitability for use with various population s of available self-report measures of weight bias .