Medical Students in Colombia Fall Short on Obesity Knowledge, Survey Reveals

Obesity has become one of the defining chronic diseases of the twenty-first century, yet the doctors of tomorrow may be strikingly unprepared to treat it. A new cross-sectional survey of 203 undergraduate medical students in Colombia has found that the median score on an obesity knowledge test was just 9.0 out of 16 items — roughly 56 percent correct — and that more than 95 percent of participants rated their own competence in managing the condition as low or intermediate. Only five students, a mere 2.4 percent of the sample, considered themselves highly competent in caring for patients living with obesity. The study, published in Discover Education, offers one of the first systematic looks at how Colombian medical training equips future physicians for a disease that now affects roughly one in six adults worldwide.

The scale of the public health backdrop makes the findings difficult to ignore. According to the World Health Organization, obesity prevalence among adults has doubled over the past decade, reaching approximately 16 percent of adults aged 18 and over by 2022. In Colombia itself, the National Survey of Nutritional Situation recorded a rise in adult obesity from 15.2 percent in 2005 to 21.3 percent in 2015. The World Obesity Federation’s Global Obesity Observatory assigns Colombia a national obesity risk score of 7.5 out of 10 — among the highest in Latin America — reflecting not only current prevalence but the speed of increase and the country’s limited capacity to meet WHO obesity targets. Excess body weight is a well-established risk factor for type 2 diabetes, hypertension, cardiovascular disease, musculoskeletal disorders, and female infertility, which means that gaps in clinical preparedness translate directly into population-level consequences.

The research team, led by Andrés M. García of Universidad Tecnológica de Pereira, recruited participants through the national network of medical student associations between January and October 2025. Respondents came from fifteen different regions of the country, with a mean age of 23 years, and were distributed across three academic stages: preclinical years one and two (35 percent), clinical years three and four (30 percent), and internship years five and six (35 percent). Each participant completed an 18-item self-administered questionnaire comprising 16 multiple-choice items and 2 open-ended questions. The closed items covered four domains — pathophysiology and etiology, diagnostic criteria, treatment goals, and long-term complication management — while the open-ended items probed perceptions of patients with obesity and self-assessed clinical competence.

The statistical analysis revealed a pattern that should concern curriculum designers. Overall knowledge scores differed significantly across the three academic groups, with clinical and internship students outperforming their preclinical peers. But the effect sizes were small, indicating that academic advancement explains only a modest proportion of the variance in knowledge. More striking still, there was no significant difference between the internship and clinical groups in any domain — suggesting that additional clinical exposure alone does not resolve the underlying educational deficit. In other words, simply rotating through hospital wards does not, by itself, turn a student into someone capable of managing a complex chronic disease.

The domain-level breakdown is perhaps the most technically revealing result. Students answered a median of four out of five items correctly on treatment goals (80 percent), and two out of three on both physiology and etiology and diagnostic criteria (67 percent each). But on complications and long-term management — the domain that captures obesity as a chronic, relapsing condition requiring indefinite follow-up, treatment intensification, and surveillance for organ damage — the median fell to just two out of five items correct, or 40 percent. The authors interpret this asymmetry as evidence that obesity is being taught as a diagnosis rather than as a longitudinal condition. Students were most secure where obesity fits the acute, single-episode model around which much of the curriculum is organized, and least secure where it demands the sustained, multimodal management that modern obesity medicine actually requires.

This matters because effective long-term obesity care is inherently longitudinal. Discontinuation of effective therapies frequently leads to weight regain and recurrence of comorbidities — a phenomenon documented in trials such as the STEP 1 extension study of semaglutide withdrawal. Durable treatment typically integrates lifestyle modification, pharmacotherapy, and, where clinically indicated, surgical approaches. If graduating physicians do not understand escalation pathways, weight regain after treatment stops, or how to screen for obesity-related organ damage, patients risk suboptimal follow-up and progressive disease. The Colombian context compounds the problem: more than sixty undergraduate medical programmes operate in the country, curricular content is defined autonomously by each institution, and national reviews describe a persistent orientation toward hospital-based, specialty-driven training rather than chronic disease prevention and primary care. No national standard guarantees exposure to obesity as a chronic disease.

The qualitative component of the survey added a troubling attitudinal dimension. Using descriptive qualitative content analysis, the researchers coded the open-ended responses and identified several recurring barriers: insufficient training, weight bias, communication apprehension, and limited awareness of the systemic determinants of obesity. In the largest category, participants attributed barriers predominantly to patient-related factors — a pattern the authors link to weight bias in clinical settings. Other students, however, pointed outward, citing structural constraints such as healthcare system barriers that prevent patients from accessing comprehensive treatment, and noting that healthy foods may be more expensive than detrimental ones. The coexistence of these two attributional orientations — one that blames the patient and one that recognizes structural constraints — was inferred from brief written answers and should be treated as a hypothesis for further study, but the authors argue it has direct implications for curriculum design, since the two orientations call for different educational interventions.

Weight stigma among healthcare professionals is extensively documented, and its consequences are not benign. Clinicians who hold negative attitudes and stereotypical beliefs about individuals with obesity may alter their clinical interactions and medical decision-making, and patients who experience stigma in healthcare settings show reduced utilization, lower treatment adherence, and diminished trust in the patient-provider relationship. Evidence even suggests that weight stigma can paradoxically promote additional weight gain, reinforcing a harmful cycle. Responses in the survey reflecting a fear of making patients uncomfortable point to weight-related communication apprehension — a barrier that cannot be dissolved with didactic lectures but requires specific training in patient-centered counseling and motivational interviewing, practised with structured feedback.

On a more encouraging note, the study found a degree of concordance between self-perceived and objectively measured competence: students reporting high competence did not outscore the intermediate group, a pattern the authors describe as consistent with developing metacognitive awareness. Yet the overwhelming predominance of low and intermediate self-ratings underscores the magnitude of the gap, and the authors caution that self-report alone is an inadequate basis for evaluating curricular reform and should be paired with objective assessment. For accreditation bodies, the study suggests a comparatively low-cost, nationally reaching measure: obesity-specific learning outcomes are currently not defined at the national level in Colombia, and making them explicit within programme licensing and accreditation criteria would remove their fate from institutional discretion.

The authors are careful about the limits of their evidence. The sample was drawn by non-probabilistic convenience sampling with self-selection, and 70 percent of respondents were enrolled in institutions in the Coffee Axis region of Risaralda, Quindío, and Caldas, so the findings describe this sample rather than the national population of medical students. The questionnaire did not record institutional type, the knowledge instrument has not been formally validated in this population, the cross-sectional design precludes causal inference, and the high-competence subgroup was too small for reliable comparison. Even with these caveats, the message is clear and urgent: substantial knowledge gaps and attitudinal barriers persist across every academic level, and closing them will require treating obesity as an explicit, longitudinally assessed competency — embedded within chronic disease blocks alongside diabetes and hypertension, reinforced through repeated patient encounters, and paired with anti-stigma training — rather than content scattered implicitly across nutrition and endocrinology lectures. International experience suggests dedicated obesity medicine modules and standardized patient encounters can improve both knowledge and attitudes; the task now, the authors conclude, is to test whether such interventions work in the Colombian context.

Subject of Research: Obesity knowledge and perceptions among undergraduate medical students in Colombia

Article Title: Knowledge and perceptions of obesity among undergraduate medical students in Colombia: a cross-sectional survey

Article References: García, A. M., González-Santamaría, J., López-García, C. J., Cruz, D. A. R., & Ramírez, J. A. (2026). Knowledge and perceptions of obesity among undergraduate medical students in Colombia: a cross-sectional survey. Discover Education, 5(1), Article 1000. https://doi.org/10.1007/s44217-026-02131-3

Image Credits: AI Generated

DOI: 10.1007/s44217-026-02131-3

Keywords: obesity, medical education, Colombia, medical students, weight stigma, cross-sectional survey, curriculum reform, chronic disease management, knowledge assessment, patient communication, public health, Knowledge