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The roles of experienced and internalized weight stigma in healthcare experiences: Perspectives of adults engaged in weight management across six countries

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Paper Summary

Paperzilla title
Weight Stigma: A Global Healthcare Headache - Internalized Bias Predicts Bad Experiences in Six Countries

Internalized weight bias (WBI) is a stronger predictor of negative healthcare experiences than simply experiencing weight stigma. People with higher WBI in six Western countries reported avoiding doctors, feeling judged, and having lower quality care. Weight stigma from doctors is extremely common, impacting care even after accounting for BMI.

Explain Like I'm Five

Scientists found that if people feel really bad about their own weight inside, it makes going to the doctor much harder and less helpful, even more than just when others are mean. Doctors often make people feel judged, so they avoid getting care.

Possible Conflicts of Interest

The study received funding from WW International (formerly Weight Watchers), and one of the authors (GDF) is an employee and shareholder of WW. While this funding source and affiliation represent potential conflicts of interest, it's important to note that the authors acknowledge these connections and claim adherence to PLOS ONE policies on sharing data and materials.

Identified Limitations

Cross-sectional design
The cross-sectional nature of the study prevents causal conclusions and requires longitudinal examination to establish the directionality of associations between weight stigma and healthcare experiences.
Self-reported data
Reliance on self-reported recall of stigma and healthcare experiences introduces potential for self-report bias and may not fully capture the complexity of these phenomena.
Limited validation of measures
The study's measure of internalized weight bias has not been validated in all languages used in the study, limiting the generalizability of findings related to this construct across all countries.
Limited sample diversity
The sample primarily consisted of White women of middle age, restricting the generalizability of findings to more diverse multinational samples with varying demographic characteristics.
Low response rate
The low response rate prevents generalizing findings to all members of the weight management program or those seeking treatment.
Data collection during pandemic
Data collection during the COVID-19 pandemic may have influenced participant responses and the survey response rate, limiting the generalizability of findings to non-pandemic contexts.

Rating Explanation

This study is the first multinational investigation of the associations between weight stigma and healthcare experiences, making a significant contribution to the field. The use of identical measures and comparable samples across countries strengthens the study's rigor, allowing for meaningful comparisons and providing valuable insights into the consistency of findings across different Western countries. The identification of internalized weight bias as a key predictor of adverse healthcare experiences is a novel and important finding. While the study's limitations regarding causality and sample diversity warrant consideration, the overall quality and impact of the research merit a strong rating. The conflict of interest is noted, but does not fundamentally compromise the methodology.

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Topic Hierarchy

Domain: Health Sciences
Subfield: Pharmacy

File Information

Original Title: The roles of experienced and internalized weight stigma in healthcare experiences: Perspectives of adults engaged in weight management across six countries
Uploaded: July 14, 2025 at 10:43 AM
Privacy: Public