Document Type (Journals)

Original Research


Anti-fat biases in healthcare providers can result in substandard and decreased care, and also result in health disparities. There are very few studies that examine occupational therapists’ attitudes towards fat people and implications on practice. Therefore, the aim of this study was to explore the implicit fat prejudice of occupational therapy students. The authors also sought to understand how this prejudice related to the occupation-based models/frames of reference with which students professionally identified. To do so, 58 occupational therapy students from three Midwestern universities, all of whom recently completed their first year of professional occupational therapy education, completed the Weight Implicit Association Test as well as a survey. Findings revealed 69.0% (n = 40) of participants preferred thin people, 12.1% (n = 7) preferred fat people, and 19.0% (n = 11) had no preference. The majority of participants moderately or strongly preferred thin people. According to a one-way ANOVA, there was also a statistically significant difference between the professional focus participants identified with and their implicit scores. Education in theoretical and occupation-based models unique to the profession hold promise for being a method for mitigating the effects of implicit bias. How students in healthcare are educated to understand and reduce their biases is critical to improving equity in care and to reduce health disparities. Grounding focus on occupation may not only strengthen professional identity but also reduce biases of clients based on social prejudices that deprive occupational opportunity.


Carli Friedman, PhD is the Director of Research for CQL | The Council on Quality and Leadership. Her research interests include modern prejudice, quality of life, and people with intellectual and developmental disabilities.

Laura H. VanPuymbrouck, PhD, OTR/L is an Assistant Professor in the department of Occupational Therapy at Rush University Chicago. Her research and teaching interests include the intersection of occupational therapy and disability studies with a particular focus on providers’ perceptions of disability influence and impact on clinical interventions.

Declaration of Interest

The authors report no declarations of interest.

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.