Table 1 Illustrative medical trainee quotes for theme 1: “I know what it’s like”

Understanding of how it feels to be mistreated because of body size

As a child, I was overweight, and I was bullied because of it for years in school. This experience has always made me have a lot of sympathy for others who are overweight because I assume they have had similar experiences and I have some sense of how it feels to be treated badly because of your body. (P170)

I still struggle with my weight to this day because of how I was pressured to be thin for so many years. It ruined my relationship with food and how I perceived myself. When I see a fat person, I see myself, I understand their struggle, and I completely empathize with their situation. (P207)

My perspective on weight is one that encompasses the experience of having gained weight throughout childhood and early life, slowly becoming morbidly obese (BMI > 35) after college, and then having lost about 100lbs to reach my current weight (BMI = ~ 22). As someone who has lived on both sides of the coin, I can say that the differences in how people treated me, and how I treated myself, are striking pre-and-post weight loss. (P104)

Impact of childhood maltreatment on self-worth

My entire life, my parents, extended family, and random family friends I did not even know would tell me I was not thin enough or that I’d gained weight, etc. Back then, I was not even overweight but their words hurt, and they made me resent my body. Since then, I have always associated being anything other than thin with negativity, and these negative connotations that I associate with being fat have only become stronger over the years as I struggle with the side effects of having hypothyroidism and have gained a lot of weight in the past five years. (P11)

My results showed that I had a slight automatic preference for thin people over fat people. I don’t find this a surprising result given the amount of self-loathing I had toward my own body as an overweight child and how our society treats fat people. Throughout my childhood, it was constantly reinforced to me that being fat was not only “gross” but meant I was undeserving of love. (P165)

Growing up…I did suffer from self esteem issues because of my weight, and [this] has made me self conscious even into my twenties…I definitely struggle with controlling my weight and even more so my own personal body image. (P87)

Understanding of the difficulties of weight loss.

I sympathize with people who are overweight or struggle with obesity because I realize there are so many factors that go into it. So many other things can be going on in life that one day you wake up and realize, I have gained a lot of weight. And it takes a lot of effort to lose that weight. (P146)

I have struggled with a metabolic disorder since I was a teenager… athletic activities masked an underlying metabolic imbalance that came out when I left for college and didn’t have time to do the 5–6 h a day of athletics I was used to. I have always watched my diet and it was very frustrating to me when as a freshman, I struggled with my weight despite not changing anything I was eating. (P77)

In the setting of a gym, I am extremely proud of those who are overweight or obese, because I know how much courage it takes to be surrounded by people in healthier shape. (P119)

Perspective on the complexity of obesity

For these reasons I always believed that weight has a very strong genetic and metabolic component–that you can control your weight to some extent, but there are a lot of things that may be easier for some people to do (i.e. gain or lose weight) that may be very difficult for others. (P75)

I was very overweight as a child and I find my weight a constant struggle. I try to maintain as healthy of a lifestyle as I can, but I acknowledge that genetics definitely play a role in weight. (P64)

Throughout my life, I have always struggled with my weight and after losing 100 pounds, I still continue to face challenges related to weight and body image. Although I was able to lose a lot of weight through Weight Watchers and exercise, I recognize that many people who struggle with their weight are not as fortunate as I am and cannot afford the expenses of healthy food, weight loss programs, or gym memberships. (P47)