People with higher BMIs may avoid care because of stigma, suggests study

A new study published in Obesity Science and Practice reveals that patients with a higher BMI may avoid seeking healthcare or switch doctors due to experiencing weight-based stigma. The study has serious implications for health outcomes in people with overweight and obesity, suggesting that stigma may contribute to morbidity by causing patients to avoid or delay seeking care for health concerns.

Phelan and colleagues surveyed 2,380 primary care patients with a BMI above 25 in the US-based LHSNet Clinical Data Research Network. Patients were given a scale to assess stigmatising situations and asked how they perceived their past experiences with health professionals in terms of respect and patient-centred communication. They were also asked whether they had delayed necessary care or sought a new doctor over the past 12 months. The results showed an association between having a higher BMI and either delaying needed care or attempting to switch doctors, and these associations were mediated by both stigma experienced in healthcare and lower patient-centred communication. This indicates that patients with obesity may be less likely to receive the healthcare they need at the appropriate time.

The study adds to a growing body of evidence that weight-based stigma from healthcare providers may worsen patient outcomes. Previous studies have indicated that, when providers treat patients with higher body weight, they tend to spend less time in appointments, are more likely to assign negative symptoms, and build less emotional rapport when compared with patients with lower body weight. This new study highlights the potential consequences of this behaviour, and highlights the need for compassionate, non-stigmatising communication between health professionals and patients with obesity.

The full study, A model of weight-based stigma in health care and utilization outcomes: Evidence from the Learning Health Systems Network, is available to read in Obesity Science and Practice via Early View.