Obesity Stigma in Medical Education: Attitudes, Beliefs and Fat Phobia among Nigerian Medical Students

Abstract

Obesity is a growing global public health concern associated with significant physical, psychological, and social consequences. Despite increasing awareness of obesity as a multifactorial condition, stigma and discriminatory attitudes toward individuals living with obesity remain prevalent, even among healthcare professionals and medical trainees. This study aimed to investigate the attitudes, beliefs, and fat phobia related to obesity among medical students in Nigerian tertiary institutions. Specifically, it sought to assess general attitudes toward individuals living with obesity, evaluate beliefs about its causes, measure the prevalence and intensity of fat phobia, and identify cultural stereotypes influencing obesity stigma. A cross-sectional descriptive survey design was employed. The study was conducted across eight accredited medical schools in Nigeria between January and June 2024. The target population consisted of clinical medical students in 400 to 600 levels. A minimum sample size of 382 was calculated, and 403 students participated. Data were collected using an online questionnaire distributed via Google Forms, which included sociodemographic information and three validated instruments: The Attitudes Toward Obese Persons Scale (ATOP), the Beliefs About Obese People Scale (BAOP), and the Fat Phobia Scale (FPS). Descriptive statistics were performed using SPSS version 25, with results presented in tables and figures. The mean age of respondents was 25.7 ± 3.33 years, with 53.1% male and 89.8% single. More than half (52.9%) expressed negative attitudes toward obese individuals, with a mean ATOP score of 58.36 ± 14.49. Beliefs were dominated by personal responsibility perceptions, with 77.9% attributing obesity to overeating or lack of exercise; mean BAOP score was 18.73 ± 7.47. Fat phobia was highly prevalent, with 66.0% of students classified as having high levels of fat phobia. Obesity stigma remains pervasive among Nigerian medical students, characterized by negative attitudes, personal responsibility beliefs, and high fat phobia. Addressing these biases early in medical education is essential to prepare future physicians to deliver compassionate, evidence-based care and reduce systemic discrimination in healthcare delivery.