Association Between Weight Stigma Experiences in Healthcare and Self-Reported Healthcare Avoidance in a National Sample

Abstract

Objectives: Although weight stigma in healthcare is common, existing measures may not capture the full range of patients' weight stigma experiences in clinical practice. We aimed to examine how physical examination by healthcare providers, communication, and the built environment perpetuate weight stigma and impact healthcare avoidance. Items from the previously developed Weight Stigma in Healthcare Inventory (WSHCI) were tested to assess weight stigma experiences and assess association with healthcare avoidance. Methods: Two sample groups, identified through ResearchMatch and a Qualtrics survey panel, completed the WSHCI online. We analyzed the association between individual items and healthcare avoidance, and between a summation of weight stigma experiences and healthcare avoidance, adjusting for demographics. Results: Five-hundred twenty four surveys were received. All weight stigma items were associated with healthcare avoidance, with the strongest associations found for items related to experiencing stigma during physical examination. Greater numbers of stigmatizing experiences were associated with healthcare avoidance (OR 1.31, 95% CI [1.26, 1.37]). Conclusions: To reduce healthcare avoidance due to weight stigma, all aspects—the physical examination, communication, overall experiences and the built environment—need to be addressed. Reducing the overall number of negative experiences and reducing weight stigma experiences during physical examination may be especially important to reduce healthcare avoidance.