Development and validation of the EDIT weight stigma reduction checklist

Weight stigma and weight discrimination refer to the negative attitudes and behaviours towards people with higher weight, because of their body size. Experiences of weight stigma in healthcare settings and within weight management interventions contribute to poor psychological and physical health and healthcare avoidance. This study aimed to develop a checklist for healthcare professionals and providers of weight management interventions to minimize weight stigmatisation, to the extent possible, in these interventions and settings.

Based on existing literature on the contributors to weight stigma in healthcare, members of the Eating Disorders In Weight-Related Therapy (EDIT) Collaboration Weight Stigma Working Group drafted and refined the checklist items using an iterative process. The items were then pilot-tested by two reviewers. A 21-item checklist, organized into four domains: (1) planning and personnel; (2) intervention design and content; (3) outcomes and monitoring; and (4) additional components, was validated via an online survey. Healthcare professionals, researchers, and individuals with lived experience of higher weight evaluated the clarity, relevance, and importance of each item. The Content Validity Index (CVI), Content Validity Ratio (CVR), and participant feedback were used to refine the final version of the checklist.

Respondents (n = 28, 79% women, M_age = 44, SD = 10.6) completed the survey. Most items were rated as clear, and 20 out of 21 items were deemed relevant to the checklist's aim (CVI range 0.61-1.0). Four items were rated as essential, with many remaining items rated as 'important but not essential'. The final checklist consists of nine items across three sections: (A) essential elements of planning/design, (B) additional considerations, and (C) feedback on the service.

The EDIT Weight Stigma Reduction Checklist has value in assisting providers to design, deliver, and implement weight management interventions to take a priori action to minimise weight stigma in practice.