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Author ORCID Identifier


Open Access Dissertation

Document Type


Degree Name

Doctor of Philosophy (PhD)

Degree Program

Public Health

Year Degree Awarded


Month Degree Awarded


First Advisor

Elena T. Carbone

Second Advisor

Jean Anliker

Third Advisor

Linnea Evans

Subject Categories

Dietetics and Clinical Nutrition | Public Health


Weight bias includes negative attitudes or judgements towards people in larger bodies. It is associated with poor health outcomes.

Weight bias is highly common in the United States, and pre-professional health students are known to exhibit it. Given its impact, finding effective interventions to reduce weight bias is important.

The first paper reviewed literature on existing interventions for weight bias reduction. The search revealed three main intervention types: targeting attributions, increasing empathy, and targeting social consensus. Interventions, regardless of strategy, yielded mixed results for weight bias reduction, and, in some cases, increased bias.

The second paper tested a novel intervention to reduce weight bias using a case study approach to measure bias. We randomly assigned 153 students enrolled in pre-health courses to receive a novel, a conventional, or a control intervention before responding to questions about a case study patient with obesity. Contrary to our hypothesis, we found that the conventional group (M=3.65, SD=0.91) rated weight as less important on overall health compared to the control condition (M=4.17, SD=0.82, p=.025)) and the control group (M= 3.28, SD=1.02) had significantly lower interest in working with the case study patient than the conventional group (M=3.74, SD=0.97, p = .007).

The third paper was a content analysis of the presentation of case study patients in nutrition counseling textbooks. We used the University of Massachusetts Amherst Libraries Global Online Bibliographic Information (GOBI) database to search for nutrition counseling textbooks published between 2009-2019 in English in the United States. The textbooks (n=3) were then reviewed, and individual case study patient data therein were analyzed.

This study found a lack of diversity in weight status, with 60% of case study patients with overweight or obesity, only 20% described as healthy weight, and no case study patients with underweight. Case study patients were also exclusively described in gender binary, and gender-based stereotypes about occupation were noted in the texts.

Together, the results of these studies show a need for further research into effective ways to reduce weight bias. The results also suggest a need to explore other types of biases that may be reinforced in college textbooks.


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Creative Commons Attribution 4.0 License
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Available for download on Friday, March 01, 2024