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Association Between Weight Stigma Experiences in Healthcare and Self-Reported Healthcare Avoidance in a National
Kathleen M Robinson1,2, Aaron M Scherer3, Alithea N Zorn4
1Department of Internal Medicine Division of Endocrinology and Metabolism University of Iowa Iowa City Iowa USA.
Obesity Science & Practice
|October 27, 2025
Summary
Weight stigma in healthcare, particularly during physical exams, drives patients to avoid medical care. Addressing all aspects of stigma, especially during examinations, is crucial to improve healthcare access.
Area of Science:
- Medical Sociology
- Health Services Research
- Patient Experience
Background:
- Weight stigma within healthcare settings is prevalent but often inadequately measured.
- Existing tools may not fully encompass patient experiences of weight bias in clinical practice.
- Weight stigma can significantly deter individuals from seeking necessary medical attention.
Purpose of the Study:
- To investigate how physical examinations, provider communication, and the healthcare environment contribute to weight stigma.
- To assess the impact of these weight stigma experiences on healthcare avoidance.
- To validate items from the Weight Stigma in Healthcare Inventory (WSHCI) for measuring these experiences.
Main Methods:
- Utilized the Weight Stigma in Healthcare Inventory (WSHCI) with two distinct online participant groups.
- Analyzed associations between specific weight stigma experiences and healthcare avoidance.
- Examined the relationship between the cumulative number of stigmatizing experiences and healthcare avoidance, controlling for demographics.
Main Results:
- All tested weight stigma items correlated with healthcare avoidance.
- Stigma experienced during physical examinations showed the strongest association with healthcare avoidance.
- A higher frequency of stigmatizing encounters significantly increased the likelihood of healthcare avoidance (OR 1.31).
Conclusions:
- Reducing healthcare avoidance necessitates addressing weight stigma in physical examinations, communication, and the built environment.
- Minimizing overall negative patient experiences and specifically those during physical exams is key.
- Interventions targeting weight stigma are vital for improving healthcare utilization among affected patients.
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