Background: Training gaps regarding the diagnosis and management of eating disorders in diverse populations, including racial, ethnic, sexual, and gender minoritized groups, have not been thoroughly examined.
Objective: This study aimed to examine resident physicians' knowledge and attitudes regarding eating disorders in diverse populations, with a focus on areas for improved training and intervention.
Methods: Ninety-two resident physicians in internal medicine, emergency medicine, obstetrics/gynecology, psychiatry, and surgery at an academic center completed an online survey from 12/1/2020-3/1/2021, which comprised multiple choice and vignette-style open-ended questions to assess knowledge and attitudes toward the management and clinical presentations of eating disorders. Overall, the survey response rate was 25.7%. Descriptive statistics were reported. Vignette-style questions were analyzed using inductive coding and the frequency of responses was reported.
Results: A minority of resident physicians self-reported confidence in their knowledge of the medical complications (n = 42, 45%), risk factors (n = 38, 41%), and clinical presentations (n = 32, 35%) associated with eating disorders. Responses to vignette-style questions correctly identified relevant management methods (such as electrolyte monitoring and referral to specialty care), but demonstrated limited knowledge of the clinical presentation of eating disorders. Furthermore, most respondents reported a lack of knowledge regarding eating disorders in sexual and gender minoritized patients (n = 68, 73.9%) as well as racial and ethnic minoritized patients (n = 64, 69.6%).
Conclusions: Our findings suggest concerning gaps in knowledge and confidence among resident physicians with regard to the diagnosis and treatment of eating disorders, particularly in racial, ethnic, sexual, and gender minoritized patients. Moreover, responses to vignette-like questions indicate significant homogeneity in respondents' perceptions of the clinical presentation of eating disorders, reflecting cultural biases which associate eating disorders with underweight, young, female patients. The majority did not feel competent in treating eating disorders in diverse populations and expressed desire for additional training in this area. More research is needed to better understand and address these gaps in eating disorder training, with the goal of increasing equity in patient outcomes.
Keywords: Eating disorders; Lgbtq; Medical education; Racial and ethnic disparities; Survey.
We investigated the knowledge and attitudes of physicians in training regarding eating disorders in diverse populations, including racial, ethnic, sexual, and gender minoritized groups. Our study surveyed 92 physicians in training from various specialties and found concerning gaps in their self-reported understanding and confidence in the diagnosis and treatment of eating disorders, particularly in minoritized populations. The findings of the survey revealed several concerning trends. A significant portion of the resident physicians reported low confidence in their knowledge of the medical complications, risk factors, and clinical presentations of eating disorders. Although they recognized some management methods, they reported limited knowledge about how eating disorders affect racial, ethnic, sexual and gender minoritized patients. Overall, the findings indicate significant gaps in the training of these resident physicians regarding eating disorders, particularly for diverse populations, and many expressed a need for more training to improve their competence in this area. Further research is necessary to better understand and address these gaps to promote equity in outcomes for patients with eating disorders.
© 2024. The Author(s).