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Behavior, Psychology and Sociology

A randomised controlled trial of a lived experience and education-based weight bias intervention for Australian healthcare students

International Journal of Obesity (2026)Cite this article

Subjects

Abstract

Background

A three-arm parallel randomised controlled trial was conducted to examine the efficacy of two brief videos for reducing healthcare students’ explicit weight bias and to identify the key messages retained from the videos.

Methods

One hundred and three university students from 15 healthcare disciplines at 14 Australian universities viewed one of three randomly assigned brief videos: (1) empathy-focused (Experience), (2) education-focused (Science), or (3) smoking-focused (Control). Participants completed explicit weight bias measures at baseline, immediate post-intervention, and 2-week follow-up. Generalised linear mixed models (complete case and per-protocol) assessed intervention efficacy. Content analysis was used to examine participants’ three main take-home messages from the videos.

Results

Per-protocol analysis showed improved clinical confidence in the Experience (vs. Control) Group (g = 0.79, p = 0.027) immediately post-intervention. Complete case analysis found immediate post-intervention improvements in the Science group for empathy (vs. Control, g = 0.74, p = 0.002; vs. Experience, g = 0.51, p = 0.039) and understanding of socioeconomic contributors to obesity (vs. Experience, g = 0.68, p = 0.005). Only the improved empathy for patients living with obesity in the Science (vs. Control, g = 0.49, p = 0.041) Group was sustained at follow-up. There were no significant differences immediately post-intervention or follow-up for the remaining outcomes. Content analysis revealed that students recognised the complexity of overweight and obesity, the existence and negative impact of weight bias within society and healthcare settings, and the need to use improved methods to reduce weight bias.

Conclusion

The two brief weight bias videos had limited efficacy in reducing Australian healthcare students’ explicit weight bias on most outcome measures, but improved students’ empathy for patients and understanding of the socioeconomic contributors to obesity. Considerable reductions in explicit weight bias may require integrating weight bias reduction strategies into university curricula, with repeated exposure.

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Fig. 1: Participant flow diagram.

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Data availability

Data will be made available upon request to author RSJ for non-commercial purposes to individuals associated with academic or public research and health institutions.

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Funding

RSJ was supported by the Research Training Program (RTP) Scholarship, Australian Government, Department of Education. BH was supported by an Australian Research Council Discovery Early Career Researcher Award (DE230100704). Funding sources had no role in study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the article for publication.

Author information

Authors and Affiliations

  1. School of Population Health, Curtin University, Bentley, WA, Australia

    Ravisha S. Jayawickrama, Briony Hill, Moira O’Connor & Blake J. Lawrence

  2. Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia

    Briony Hill & Chloe Tran

  3. School of Psychology, University of Leeds, Yorkshire, UK

    Stuart W. Flint

  4. Scaled Insights, Nexus, University of Leeds, Yorkshire, UK

    Stuart W. Flint

  5. The Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, Stockholm, Sweden

    Erik Hemmingsson

Authors
  1. Ravisha S. Jayawickrama
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Contributions

RSJ was responsible for study conceptualisation, methodology, data analysis, writing—original draft, review and editing, and project administration. BH was responsible for study conceptualisation, methodology, supervision, and writing—review and editing. CT was responsible for assisting with the content analysis and writing—review and editing. MOC, SWF, and EH were responsible for writing—review and editing. BJL was responsible for study conceptualisation, methodology, supervision, and writing—review and editing.

Corresponding author

Correspondence to Ravisha S. Jayawickrama.

Ethics declarations

Competing interests

SWF reports research grants and support for attending meetings from UK National Institute for Health Research, Public Health England, UK Office of Health Improvement & Disparities, UK Doncaster Council, West Yorkshire Combined Authority, Novo Nordisk, Johnson & Johnson, University of Leeds UK, the UK Royal College of Physicians, UK Parliament, UK Safefood, Novo Nordisk Foundation, and Diabetes Ireland Congress and Exhibition, as well as an unpaid leadership role at Obesity UK. EH reports receiving royalty fees for a book published on the topic of weight stigma. All declared interests relate outside the submitted manuscript. RSJ, BH, CT, MO, and BJL declare no competing interests.

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Jayawickrama, R.S., Hill, B., Tran, C. et al. A randomised controlled trial of a lived experience and education-based weight bias intervention for Australian healthcare students. Int J Obes (2026). https://doi.org/10.1038/s41366-026-02040-3

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