Exercise-Based Obesity Simulation and Weight Bias

This randomized controlled trial evaluated the impact of an exercise-based obesity simulation on weight bias and professional competencies among undergraduate health professions students. Participants (N = 107) were randomized in a 1:1:1 ratio to one of three conditions: (1) control (professional communication module and low-intensity stretching), (2) moderate-intensity treadmill exercise without simulation, or (3) treadmill exercise while wearing an adjustable obesity simulation suit representing approximately 20% additional body mass. The intervention consisted of a single 30-minute session. Outcomes were assessed at baseline, 1-week follow-up, and 8-week follow-up. The primary outcome was change in implicit weight bias measured using the Weight Implicit Association Test. Secondary outcomes included explicit weight bias (Anti-Fat Attitudes Questionnaire; Fat Phobia Scale), empathy (Jefferson Scale of Empathy - Health Professions Student version), clinical decision-making using structured patient vignettes, behavioral intentions toward future patients, and structured reflective learning. Physiological and perceptual responses during the intervention (heart rate, perceived exertion, discomfort, and affective valence) were also recorded to examine associations between experiential intensity and learning outcomes. The study aims to evaluate whether a brief experiential educational intervention can reduce weight bias and improve empathy and clinical reasoning relevant to weight-inclusive care.