The effect of obesity on medical students' approach to patients with abdominal pain

Because widely held stereotypes characterize obese people as less intellige nt, unhappy, lacking in self control and more prone to psychological proble ms, we tested whether obese appearance alone would affect medical students' decisions about the diagnosis and management of simulated patients. We vid eotaped 4 patient simulators presenting each of 4 cases in 2 states: normal and obese (by using padding and bulky clothing). Seventy-two clinical stud ents at 2 medical schools viewed the cases and answered questions about dia gnostic tests and management. We found the expected biases toward patients when in their obese form as well as pessimism about patient compliance and success of therapy, but there were no significant differences in tests or t reatments ordered except where appropriate for an obese patient (e.g., weig ht reduction diet). Thus, the appearance of obesity alone biased the studen ts' impressions of the patients, but did not affect diagnostic test orderin g.