Medical Schools Team Up to Close a Glaring Gap in Obesity Training

Obesity now touches nearly every corner of internal medicine, shaping the course of diabetes, cardiovascular disease, sleep disorders, and a long list of cancers, yet the physicians expected to manage it often receive strikingly little formal instruction in how to do so. A new study published in the Journal of General Internal Medicine suggests that this educational blind spot can be addressed at scale, and that the fix may be less about inventing new content than about organizing existing expertise across institutions. Researchers led by Magdalena Pasarica of the University of Central Florida College of Medicine, together with Robert F. Kushner of Northwestern University Feinberg School of Medicine and a broad network of collaborators, report the results of a multi-institutional, competency-based obesity medicine curriculum implemented at eight diverse US medical schools between September 2023 and October 2025.

The scale of the evaluation is what sets the work apart. Rather than piloting a course at a single enthusiastic campus, the team surveyed learners across all eight schools, collecting pre-intervention responses from 1,829 students, roughly 60 percent of those invited, and post-intervention responses from 1,187 students, about 39 percent. Each student rated themselves on 32 distinct obesity medicine competencies and completed measures of their beliefs, attitudes, and knowledge about obesity both before and after the curriculum. This learner-perspective design matters because, as the authors note, no prior studies had evaluated competency-based obesity education interventions from the point of view of the students actually experiencing them.

The results were consistent and statistically robust. After the intervention, students reported significantly higher self-ratings across all 32 competencies, with mean scores rising from 2.79 to 3.15 on the study’s rating scale, a difference the authors report as significant at p less than 0.001. Self-assessed knowledge about obesity also improved, moving from a mean of 2.92 to 3.00. Perhaps most strikingly, the curriculum appeared to shift the emotional and attitudinal dimensions of obesity care: negative beliefs about patients with obesity dropped from a mean of 2.82 to 2.08, while positive attitudes toward patients with obesity rose dramatically, from 1.53 to 3.55. In a field where weight bias among clinicians is well documented and can degrade the quality of care patients receive, that attitudinal shift may be as consequential as any gain in technical knowledge.

The architecture of the intervention reflects two well-established ideas from education science. The curriculum was grounded in social constructivist learning theory, the view that learners build understanding through dialogue and shared practice rather than passively absorbing information, and it was guided by a logic model framework, a planning tool that links program activities to expected outcomes so that implementation and evaluation proceed together. In practice, this meant that dialogue within school-based teams was supported by an expert steering committee that provided scaffolding and expertise. Each participating institution retained local control over curricular content, with faculty champions deciding how to adapt shared materials, combine them with other evidence-based resources, or develop original educational interventions of their own.

That balance between national coordination and local autonomy was deliberate, and it speaks to a persistent tension in medical education reform. A one-size-fits-all obesity curriculum risks ignoring the realities of individual schools, their patient populations, their faculty strengths, and their existing course structures. But leaving each school to improvise alone reproduces the very fragmentation that created the education gap in the first place. The collaborative framework tested here, in which a shared set of 32 competencies anchors the effort while content decisions stay local, offers a template that other under-taught areas of medicine might copy. The competency framework itself was not invented for this study; it draws on the Obesity Medicine Education Collaborative’s competencies for medical education, published in 2019, which gave the project an externally developed, nationally recognized benchmark.

The stakes of this curricular gap are not abstract. Obesity contributes to many of the chronic diseases that internists manage daily, and recent reviews in JAMA Internal Medicine have emphasized that primary care clinicians are increasingly expected to initiate and manage obesity treatment, including newer pharmacotherapies, without having received systematic training in them. Surveys of primary care residents have documented gaps in both knowledge and practice, and the American Heart Association issued a scientific statement in 2024 calling for better implementation of obesity science into clinical practice. The American Medical Association has formally recognized the obesity crisis, and the Association of American Medical Colleges has flagged the need for action. Against that backdrop, the finding that a structured, competency-based intervention can move student self-ratings across an entire multi-school network is a meaningful proof of concept.

The study’s methods deserve scrutiny, as self-reported outcomes always do. Students rated their own competence, knowledge, and attitudes rather than being tested through objective examinations or observed clinical encounters, so the results capture perceived readiness rather than demonstrated skill. Self-assessment in medical education is known to be imperfect, and learners can overestimate or underestimate their abilities. The response rate also fell between the pre- and post-intervention surveys, from 60 percent to 39 percent, raising the possibility that the students who completed both were systematically different from those who did not. The authors frame the work as a pilot and as a quality improvement initiative, approved by the Northwestern University Institutional Review Board as such, and the emphasis is on feasibility and scalability rather than definitive causal proof.

Funding and conflict-of-interest disclosures are also part of the story, and the authors are unusually explicit about the safeguards employed. The study was funded by an unrestricted educational grant awarded to The Obesity Society by Novo Nordisk, but the funder had no role in study design, selection or delivery of curricular content, data collection, management, analysis, or interpretation. The externally developed national competency framework, local determination of content by faculty champions, the participation of eight institutions, and the freedom of those champions to ignore shared materials altogether were all designed to insulate the educational intervention from commercial influence. Several individual authors disclosed research or consultant funding from Novo Nordisk, and two serve on its advisory board, disclosures the journal publishes alongside the article.

What emerges from the eight-school experiment is less a finished curriculum than a working model of collaborative curricular change. The FORWARD initiative, as the program is known, demonstrates that a network of medical schools can align around a shared competency framework, implement locally tailored interventions, and measure movement in learner-reported competence, knowledge, and attitudes at a scale that single-campus studies cannot match. The authors argue that this large, multi-institutional approach demonstrates the feasibility and scalability of a collaborative framework for addressing the curricular gap in obesity medicine education, and the data they present, spanning nearly 3,000 survey responses across diverse institutions, lend that claim considerable weight.

The broader implications extend well beyond obesity. Medical curricula everywhere lag behind clinical science in areas that evolve quickly, from obesity pharmacotherapy to genomics to climate-related health risks, and the traditional mechanism for catching up, waiting for textbook publishers and national boards to incorporate new material, moves too slowly. The model tested here suggests an alternative: define competencies nationally, let local faculty champions construct the teaching, support them with expert scaffolding, and evaluate the result through the learners themselves. If the attitudinal gains reported in this study prove durable as these students enter residency and practice, the payoff could be measured not just in test scores but in the quality and compassion of care delivered to the growing number of patients living with obesity.

Subject of Research: A multi-institutional competency-based obesity medicine education intervention for US medical students

Article Title: Self-Reported Obesity Medicine Competence, Knowledge, and Attitudes Among US Medical Students: An Eight-School Pre- vs. Post-Intervention Study

Article References: Pasarica, M., Kushner, R. F., Leary, A. V., Mirando, A., Correa, R., Agarwal, M., Grunvald, E., Velasquez, S. T., Uhley, V., Purnell, J. Q., Carpenter, D.-A., Velazquez, A., Smolarz, G., the FORWARDQI group, Croniger, C., Johnson, M. S., Loza, J., Mock, A., & Pfotenhauer, K. (2026). Self-Reported Obesity Medicine Competence, Knowledge, and Attitudes Among US Medical Students: An Eight-School Pre- vs. Post-Intervention Study. Journal of General Internal Medicine. https://doi.org/10.1007/s11606-026-10913-6

Image Credits: AI Generated

DOI: 10.1007/s11606-026-10913-6

Keywords: obesity medicine, medical education, competency-based education, medical students, curriculum intervention, weight bias, internal medicine, social constructivist learning, logic model, multi-institutional collaboration, Journal of General Internal Medicine, physician training