Weight bias and health care utilization: A scoping review
Open accessAbstract
Aim: The purpose of this scoping review was to explore the evidence on how perceptions and/or experiences of weight bias in primary health care influence engagement with and utilization of health care services by individuals with obesity. Background: Prior studies have found discrepancies in the use of health care services by individuals living with obesity; a greater body mass index has been associated with decreased health care utilization, and weight bias has been identified as a major barrier to engagement with health services. Methods: PubMed was searched from January 2000 to July 2017. Four reviewers independently selected 21 studies examining perceptions of weight bias and its impact on engagement with primary health care services. Findings: A thematic analysis was conducted on the 21 studies that were included in this scoping review. The following 10 themes were identified: contemptuous, patronizing, and disrespectful treatment, lack of training, ambivalence, attribution of all health issues to excess weight, assumptions about weight gain, barriers to health care utilization, expectation of differential health care treatment, low trust and poor communication, avoidance or delay of health services, and ‘doctor shopping’. Overall, our scoping review reveals how perceptions and/or experiences of weight bias from primary care health professionals negatively influence patient engagement with primary health care services.
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Written from the paper’s full text.
TL;DR
This scoping review of 21 studies found that perceptions and/or experiences of weight bias from primary care health professionals negatively influence patient engagement with primary health care. It identifies 10 themes, including disrespectful treatment, low trust, avoidance or delay of services, and “doctor shopping.”
Key findings
- Across 21 included studies, thematic analysis identified 10 themes: contemptuous, patronizing, and disrespectful treatment; lack of training; ambivalence; attribution of all health issues to excess weight; assumptions about weight gain; barriers to health care utilization; expectation of differential health care treatment; low trust and poor communication; avoidance or delay of health services; and “doctor shopping.”
- Quantitative findings included: 21% perceived weight-related judgment from their primary care provider and were less likely to trust them; 13% reported prior doctor shopping due to differential treatment; 17% changed primary care physicians due to perceived indifference or negative attitudes toward bariatric surgery; 19% would avoid a medical appointment and 21% would seek a new doctor if they felt stigmatized about weight.
- Avoidance/delay findings included: 32% of women with obesity and 55% of women with severe obesity reported delaying or canceling appointments because they knew they would be weighed; 12.7% reported delaying or canceling a physician appointment due to weight concerns; 2.6% attended but refused to be weighed. In severe obesity, health care stigmatization was associated with a 1.5 kg/m² increase in BMI.
- Four studies did not report decreased health care utilization: Bottone et al. found 29.6% of patients with obesity versus 23.4% of normal-weight patients visited their primary care provider three or more times in the past six months; Hilbert et al. found greater BMI predicted greater weight bias internalization and greater health care utilization.
Methods
- Scoping review using Arksey and O’Malley’s methodology and PRISMA-ScR reporting; PubMed was searched from January 2000 to July 2017, limited to English and French.
- Four independent reviewers screened titles, abstracts, and full texts; 720 unique articles plus 12 additional articles yielded 732 screened records, of which 21 studies met inclusion criteria.
- Data were charted for study characteristics, patient population, and outcomes, then synthesized using thematic analysis.
Limitations
- Stated: the review focused primarily on weight bias in primary care health professionals, so conclusions can only be made about primary care health professionals; three papers reported three different outcomes from the same sample, which may be viewed as a limitation; future research is needed in other health sectors and settings.
- Stated/evident: scoping review methodology is not intended to assess study quality or provide quantitative synthesis; findings were inconsistent across studies; the evidence base was predominantly US-based (71.4%), quantitative (62%), female-only in 47.6% of studies, and only 38.1% included exclusively participants with obesity, with a noted lack of literature on men’s engagement.
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Claims the paper makes
0 of 93 cited sources checked · 0 supported · 0 flagged
- Findingcitation
Participants perceived weight-related advice from health professionals as patronizing when health professionals insinuated there was a simple solution to patients' excess weight.
“Participants perceived that weight-related advice from health professionals was delivered in a patronizing manner when health professionals insinuated that there was a simple solution to patients’ excess weight (Merrill and Grassley, 2008).”
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- Findingcitation
Four studies reported that participants with overweight and obesity experienced contemptuous, patronizing, and/or disrespectful treatment from health professionals.
“Four studies (Amy et al., 2006; Merrill and Grassley, 2008; Russell and Carryer, 2013; Buxton and Snethen, 2013) reported that participants with overweight and obesity experienced contemptuous, patronizing, and/or disrespectful treatment from health professionals.”
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- cites Merrill and Grassley, 2008
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- cites Russell and Carryer, 2013
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- Findingcitation
Participants with overweight and obesity reported feeling treated less respectfully than individuals classified as having a normal BMI.
“Participants with overweight and obesity reported feeling that they were being treated less respectfully than individuals classified as having a normal BMI (Amy et al., 2006).”
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- Findingcitation
Participants living with overweight and obesity perceived a lack of training among health professionals.
“Participants living with overweight and obesity perceived a lack of training among health professionals (Amy et al., 2006; Forhan et al., 2013; Russell and Carryer, 2013).”
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- cites Forhan et al., 2013
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- cites Russell and Carryer, 2013
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- Findingown data
Only participants with obesity were included in 38.1% (n=8) of the studies.
“Only participants with obesity were included in 38.1% (n = 8) of the studies.”
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- Findingown data
Almost half of the studies (n=9, 42.9%) exclusively involved primary care physicians or nurse practitioners who work in general practice.
“Almost half of the studies [n = 9 (42.9%)] exclusively involved primary care physicians or nurse practitioners who work in general practice.”
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Almost 80% of women with obesity in one study rarely or never had been treated disrespectfully by their health professionals when discussing weight management.
“One study that exclusively examined women with obesity reported that almost 80% of participants rarely or never had been treated disrespectfully (e.g., insulted or criticized for not trying hard enough) by their health professionals when discussing weight management (Wadden et al., 2000).”
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- Findingcitation
Over half of sampled health professionals reported they had no specific education on providing clinical gynecological examinations for patients with obesity.
“Amy et al. showed that over half of their sampled health professionals reported that they had no specific education on providing clinical gynecological examinations for patients with obesity (Amy et al., 2006).”
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- Findingcitation
Over 60% of patients complained that their physicians did not truly understand how difficult it was to be overweight.
“Wadden et al. showed that over 60% of patients complained that their physicians did not truly understand how difficult it was to be overweight (Wadden et al., 2000).”
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- Findingcitation
24% of patients reported that their primary care practitioners sometimes did not believe them when they told them they do not eat that much.
“In the same study, 24% of patients reported that their primary care practitioners sometimes did not believe them when they told them they do not eat that much.”
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- Findingcitation
Barriers to health care utilization among individuals with overweight or obesity included unsolicited lecturing about weight loss.
“Barriers to health care utilization included unsolicited lecturing about weight loss (Olson et al., 1994; Wadden et al., 2000; Drury and Louis, 2002; Pryor, 2002; Amy et al., 2006; Ferrante et al., 2016);”
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- cites Wadden et al., 2000
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- cites Drury and Louis, 2002
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- Findingcitation
Barriers included not wanting to get weighed.
“not wanting to get weighed (Olson et al., 1994; Drury and Louis, 2002);”
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- cites Drury and Louis, 2002
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- Findingcitation
Attribution of all health issues to excess weight affected patients' health utilization by increasing their reluctance to disclose the events surrounding the emergence of their symptoms, to see their general practitioner, or to express concern about a health issue.
“Attribution of all health issues to excess weight affected patients’ health utilization by increasing their reluctance to disclose the events surrounding the emergence of their symptoms, to see their general practitioner, or to express concern about a health issue (Brown et al., 2006).”
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- Findingcitation
Barriers included a fear of exposing their bodies.
“a fear of exposing their bodies (Russell and Carryer, 2013);”
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- Findingcitation
Barriers included feeling embarrassed about their weight.
“feeling embarrassed about their weight (Amy et al., 2006; Forhan et al., 2013);”
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- cites Forhan et al., 2013
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- Findingcitation
Patients with obesity expected to receive different health care treatments because of their weight.
“Patients with obesity expected to receive different health care treatments because of their weight (Brown et al., 2006; DeJoy et al., 2016).”
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- cites DeJoy et al., 2016
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- Findingcitation
Seven studies cited reasons for avoidance, delay, or cancellation of health care services observed with individuals with overweight or obesity.
“Seven studies (Olson et al., 1994; Drury and Louis, 2002; Pryor, 2002; Amy et al., 2006; Forhan et al., 2013; Russell and Carryer, 2013; Ferrante et al., 2016) cited reasons for avoidance, delay, or cancellation of health care services observed with individuals with overweight or obesity.”
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- cites Drury and Louis, 2002
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- cites Pryor, 2002
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- Findingcitation
Patients indicated that health professionals often made assumptions about what it is like to live with obesity.
“Patients indicated that health professionals often made assumptions about what it is like to live with obesity (Wadden et al., 2000; Pryor, 2002; Merrill and Grassley, 2008; Forhan et al., 2013; DeJoy et al., 2016; Ferrante et al., 2016).”
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- cites Pryor, 2002
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- cites Merrill and Grassley, 2008
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- Findingcitation
Barriers included inadequate hospital equipment such as small gowns, examination tables, chairs, and blood pressure cuffs.
“and inadequate hospital equipment such as small gowns, examination tables, chairs, and blood pressure cuffs (Pryor, 2002; Kaminsky and Gadaleta, 2002; Amy et al., 2006; Merrill and Grassley, 2008).”
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- cites Kaminsky and Gadaleta, 2002
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- cites Amy et al., 2006
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- Findingcitation
Two studies reported patient ambivalence concerning the use of health services.
“Two studies (Brown et al., 2006; DeJoy et al., 2016) reported on patient ambivalence concerning the use of health services.”
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- cites DeJoy et al., 2016
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- Findingcitation
In maternity care, women with obesity reported mixed feelings about whether to attend antenatal and postpartum appointments as a result of insensitive behavior from past and current health professionals.
“In maternity care, women with obesity reported mixed feelings about whether or not to attend their antenatal and postpartum appointments as a result of the insensitive behavior they received from both past and current health professionals (DeJoy et al., 2016).”
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- Findingcitation
Patients with obesity complained of health professionals' tendencies to attribute all of their other health issues to their excess weight.
“Patients with obesity complained of health professionals’ tendencies to attribute all of their other health issues to their excess weight (Amy et al., 2006; Brown et al., 2006; Merrill and Grassley, 2008; Forhan et al., 2013; Russell and Carryer, 2013; Ferrante et al., 2016).”
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- cites Brown et al., 2006
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- cites Merrill and Grassley, 2008
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- Findingcitation
Patients with overweight and obesity who felt their primary care providers judged their weight were less likely to report high trust in these primary care practitioners.
“Patients with overweight and obesity who felt their primary care providers judged their weight were less likely to report high trust in these primary care practitioners (Gudzune et al., 2014a).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Gudzune et al., 2014a
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- Findingreasoning
This scoping review identified perceived weight bias in primary health care evidenced by health care providers' contemptuous, patronizing, and disrespectful treatment, lack of training, ambivalence, attribution and assumptions about patients' weight and health.
“This scoping review first identified perceived weight bias in primary health care evidenced by health care providers’ contemptuous, patronizing, and disrespectful treatment, lack of training, ambivalence, attribution and assumptions about patients’ weight and health.”
Quote in the paperSubstantial claim - Findingcitation
32% of women with obesity and 55% of women with severe obesity reported delaying or canceling health care appointments because they knew they would have to be weighed during the appointment.
“Olson et al. reported that 32% of women with obesity and 55% of women with severe obesity reported delaying or canceling health care appointments because they knew they would have to be weighed during the appointment (Olson et al., 1994).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Olson et al., 1994
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- Findingcitation
17% of participants changed primary care physicians due to physician indifference and negative attitudes toward bariatric surgery.
“Another study reported that 17% of participants changed primary care physicians due to physician indifference and negative attitudes toward bariatric surgery (Kaminsky and Gadaleta, 2002).”
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- Findingcitation
74% of patients with overweight and obesity reported a high level of trust (scores ≥ 8) in their current primary care practitioner.
“a study, which asked participants to rate on a scale of 0–10 their level of trust in their current primary care practitioner, indicated that 74% of patients with overweight and obesity reported a high level of trust (scores ≥ 8) in their primary care practitioner.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Gudzune et al., 2014b
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- Findingcitation
There is a major gap in health professional training programs on obesity and weight bias.
“There is a major gap in health professional training programs on obesity and weight bias (Amy et al., 2006; Forhan et al., 2013; Russell and Carryer, 2013).”
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- cites Forhan et al., 2013
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- cites Russell and Carryer, 2013
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- Findingcitation
21% of participants reported they would look for a new doctor if they perceived stigmatization about their weight.
“In one study, 21% of participants reported that they would look for a new doctor if they perceived stigmatization about their weight (Puhl et al., 2013).”
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- Findingcitation
During physician visits, primary care providers demonstrated lower levels of emotional rapport with patients with obesity and overweight compared to normal weight patients.
“During physician visits, primary care providers demonstrated lower levels of emotional rapport with patients with obesity and overweight compared to normal weight patients (Gudzune et al., 2013).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Gudzune et al., 2013
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- Findingcitation
13% of participants with overweight and obesity had cited previous doctor shopping as a result of differential treatment.
“Gudzune et al. reported that 13% of participants with overweight and obesity had cited previous doctor shopping as a result of differential treatment (Gudzune et al., 2014b).”
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- Findingcitation
19% of participants stated they would avoid medical appointments if they perceived weight stigma.
“In terms of routine checkups, Puhl et al. reported that 19% of participants stated that they would avoid medical appointments if they perceived weight stigma (Puhl et al., 2013).”
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- Findingcitation
The majority of self-identified large-bodied women (BMI not reported) admitted to delaying and avoiding pelvic and breast examinations due to fears of judgment when exposing their bodies.
“Similarly, Russell and Carryer found that the majority of self-identified large-bodied women (BMI not reported) admitted to delaying and avoiding pelvic and breast examinations due to fears of judgment when exposing their bodies (Russell and Carryer, 2013).”
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- Findingcitation
The majority of participants with obesity did not delay nor avoid health care.
“Buxton and Snethen reported that the majority of participants with obesity did not delay nor avoid health care (Buxton and Snethen, 2013).”
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- Findingcitation
Two-thirds of participants reported at least one negative maternity care experience with health professionals when their weight was the focus of the interaction.
“Two-thirds of the participants reported at least one negative maternity care experience with health professionals when their weight was the focus of the interaction.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites DeJoy et al., 2016
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- Findingcitation
Seven studies found that weight bias among health professionals was associated with patient avoidance or delay of preventive screening, maternity, and general practitioner healthcare services.
“Seven studies found that weight bias among health professionals was associated with patient avoidance or delay of preventive screening, maternity, and general practitioner healthcare services (Olson et al., 1994; Drury and Louis, 2002; Pryor, 2002; Amy et al., 2006; Russell and Carryer, 2013; Puhl et al., 2013; Hansson and Rasmussen, 2014).”
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- cites Drury and Louis, 2002
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- cites Pryor, 2002
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- Findingcitation
29.6% of patients with obesity reported visiting with their primary care provider three or more times in the past six months compared to 23.4% of patients with normal weight.
“Further, Bottone et al. reported that 29.6% of patients with obesity reported visiting with their primary care provider three or more times in the past six months compared to 23.4% of patients with normal weight (Bottone et al., 2014).”
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- Findingcitation
Most pregnant or postpartum women with obesity in one study expected differential maternity care due to their weight.
“A study that exclusively involved pregnant or postpartum women with obesity reported that most participants expected differential maternity care due to their weight (DeJoy et al., 2016).”
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- Premisecitation
Increasing body mass index is associated with decreased use of health care services.
“a greater body mass index has been associated with decreased health care utilization”
- Also stated in: § Introduction · boosted
“Studies have documented a decrease in the use of health care services associated with an increasing body mass index (BMI)”
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- cites Fontaine et al., 1998
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- cites Amy et al., 2006
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- Also stated in: § Introduction · boosted
- Premisecitation
Having obesity impedes access to health care.
“In fact, it has been shown that having obesity impedes access to health care”
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- cites Amy et al., 2006
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- Premisecitation
Prior studies have found discrepancies in the use of health care services by individuals living with obesity.
“Prior studies have found discrepancies in the use of health care services by individuals living with obesity”
- Also stated in: § Introduction · plain
“Discrepancies in the usage of health care services by individuals living with obesity have been reported in prior research”
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- cites Coughlin et al., 2004
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- cites Ferrante et al., 2007
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- Also stated in: § Introduction · plain
- Premisecitation
Weight bias and stigma has been identified as a barrier to seeking health care services.
“Weight bias and stigma, known as negative, prejudicial, or stereotypical beliefs and attitudes toward individuals based on their size, has been identified as a barrier to seeking health care services”
Quote in the paperSubstantial claim0 of 3 sources checked- cites Drury and Louis, 2002
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- cites Puhl and Heuer, 2009
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- cites Washington, 2011
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- Premisecitation
Weight bias negatively impacts health care treatment outcomes.
“but it also negatively impacts health care treatment outcomes”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Carels et al., 2009
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- Interpretationreasoning
The stigma experienced by individuals with obesity may impede the adoption and maintenance of healthy behaviors.
“These studies suggest that the stigma experienced by individuals with obesity may impede the adoptions and maintenance of healthy behaviors.”
Quote in the paperSubstantial claim - Premisecitation
Individuals with obesity have reduced rates of routine breast and gynecological cancer screening tests compared to individuals with a BMI classified as normal.
“This includes reduced rates of routine breast and gynecological cancer screening tests among individuals with obesity compared to individuals with a BMI classified as normal”
Quote in the paperSubstantial claim0 of 3 sources checked- cites Adams et al., 1993
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- cites Fontaine et al., 1998
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- cites Aldrich and Hackley, 2010
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- Premisecitation
Among people with severe obesity, those who experienced weight bias had a 1.5 kg/m2 greater BMI compared to those who did not report weight bias.
“Those who experienced weight bias had a 1.5 kg/m2 greater BMI compared to those who did not report weight bias”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Hansson and Rasmussen, 2014
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- Premisecitation
Health professionals, specifically health care specialists in obesity treatment, hold strong implicit negative attitudes about individuals living with obesity.
“It has been reported that health professionals, specifically health care specialists in obesity treatment, hold strong implicit negative attitudes about individuals living with obesity”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Teachman and Brownell, 2001
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- Interpretationown data
Overall, perceptions and/or experiences of weight bias from primary care health professionals negatively influence patient engagement with primary health care services.
“Overall, our scoping review reveals how perceptions and/or experiences of weight bias from primary care health professionals negatively influence patient engagement with primary health care services.”
Quote in the paperSubstantial claim - Premisecitation
Participants who associated their obesity with more negative traits (higher weight bias) were more likely to drop out of an 18-week behavioral weight loss program compared to participants with lower levels of weight bias.
“participants who associated their obesity with more negative traits (higher weight bias) were more likely to drop out of an 18-week behavioral weight loss program compared to participants who evidenced lower levels of weight bias”
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- Interpretationreasoning
Avoidance of health care services by individuals with obesity could have detrimental implications for the prevention and management of obesity, its possible comorbidities, and other diseases.
“In this way, the avoidance of health care services could have detrimental implications for the prevention and management of obesity, its possible comorbidities, and other diseases”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Phelan et al., 2015
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- Interpretationreasoning
Because the scoping review focused primarily on weight bias in primary care health professionals, conclusions drawn from it can only be made about primary care health professionals.
“However, because our scoping review focused primarily on weight bias in primary care health professionals, conclusions drawn from this scoping review can only be made about primary care health professionals.”
Quote in the paperSubstantial claim - Interpretationreasoning
The results of this review indicate that patients with overweight and obesity delay or avoid health care services as a result of health professionals' weight bias.
“The results of this review indicate that patients with overweight and obesity delay or avoid health care services as a result of health professionals’ weight bias.”
Quote in the paperSubstantial claim- Rests on an assumption: The association between weight bias and avoidance or delay of health care is causal.
- Classified as probably not a substantial claim. 18
- May combine two claims. 13
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Findingnone givenThese studies did not explicitly mention the types of primary health care services that the health professionals performed.
“These studies did not explicitly mention the types of primary health care services that the health professionals performed.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataThe remaining 47.6% of studies included only female participants (n=10).
“The remaining 47.6% included only female participants (n = 10).”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataOf 732 screened articles, 21 studies met the inclusion criteria and were included in the review.
“Of the 732 articles that we screened as potentially relevant, 21 studies met the inclusion criteria and were included in the review”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataSurveys were the most commonly used measure in quantitative studies (n=13, 62%).
“Surveys were the most commonly used measure in quantitative studies [n = 13 (62%)].”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataOther studies (n=12, 57%) compared different combinations of underweight, normal weight, overweight, and obese BMI classifications.
“Other studies [n = 12 (57%)] compared different combinations of underweight, normal weight, overweight, and obese BMI classifications.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Findingown dataAn additional 12 articles were identified from other sources, resulting in a total of 732 articles.
“An additional 12 articles were identified from other sources resulting in a total of 732 articles.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataThe literature search resulted in 720 unique articles.
“The literature search resulted in 720 unique articles.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Findingown dataThe most commonly used qualitative method was interviews (n=7, 33%), including focus groups (n=1, 4.8%), telephone (n=1, 4.8%), face-to-face (n=4, 19%), or a combination of face-to-face and telephone (n=1, 4.8%).
“The most commonly used qualitative method was interviews [n = 7 (33%)] including focus groups [n = 1 (4.8%)], telephone [n = 1 (4.8%)], face-to-face [n = 4 (19%)], or a combination of face-to-face and telephone [n = 1 (4.8%)].”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataAnother 28.6% of studies did not exclusively examine one health sector (n=6).
“Another 28.6% of studies did not exclusively examine one health sector (n = 6).”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataOne study did not measure participant BMI (4.8%).
“One study did not measure participant BMI (4.8%).”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataThe majority of included studies used quantitative methods (n=13, 62%).
“and used quantitative methods [n = 13 (62%)]”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataThe majority of included studies were carried out in the United States (n=15, 71.4%).
“The majority of studies included in this review were carried out in the United States [n = 15 (71.4%)]”
Quote in the paperNot a substantial claimMay combine two claims.
Findingown dataThe thematic analysis identified 10 themes: contemptuous, patronizing, and disrespectful treatment, lack of training, ambivalence, attribution of all health issues to excess weight, assumptions about weight gain, barriers to health care utilization, expectation of differential health care treatment, low trust and poor communication, avoidance or delay of health services, and 'doctor shopping'.
“The following 10 themes were identified: contemptuous, patronizing, and disrespectful treatment, lack of training, ambivalence, attribution of all health issues to excess weight, assumptions about weight gain, barriers to health care utilization, expectation of differential health care treatment, low trust and poor communication, avoidance or delay of health services, and ‘doctor shopping’.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Findingown dataThe majority of included studies had mixed samples of both female and male participants (n=11, 52.4%).
“The majority of the studies included mixed samples of both female and male participants [n = 11 (52.4%)].”
Quote in the paperNot a substantial claimMay combine two claims.
FindingcitationPatients felt that the emphasis health professionals put on their weight distracted from other health issues and resulted in feelings of not being listened to.
“Patients felt that the emphasis health professionals put on their weight distracted from other health issues and resulted in feelings of not being listened to (Brown et al., 2006; Russell and Carryer, 2013).”
Quote in the paperSubstantial claim0 of 2 sources checked- cites Brown et al., 2006
Not checked in the free run.
- cites Russell and Carryer, 2013
Not checked in the free run.
May combine two claims.
FindingcitationThese types of assumptions were often inaccurate, but health professionals did not listen when patients made efforts to correct them.
“These types of assumptions were often inaccurate, but health professionals did not listen when patients made efforts to correct them (Pryor, 2002; Merrill and Grassley, 2008; DeJoy et al., 2016).”
Quote in the paperSubstantial claim0 of 3 sources checked- cites Pryor, 2002
Not checked in the free run.
- cites Merrill and Grassley, 2008
Not checked in the free run.
- cites DeJoy et al., 2016
Not checked in the free run.
May combine two claims.
FindingcitationAlthough seven studies reported the association between weight bias and decreased health care utilization, four studies reported different findings.
“Although seven studies reported the association between weight bias and decreased health care utilization, four studies reported different findings (Merrill and Grassley, 2008; Buxton and Snethen, 2013; Hilbert et al., 2014; Bottone et al., 2014).”
Quote in the paperNot a substantial claim0 of 3 sources checked- cites Merrill and Grassley, 2008
Not checked in the free run.
- cites Buxton and Snethen, 2013
Not checked in the free run.
- cites Hilbert et al., 2014
Not checked in the free run.
May combine two claims.
FindingcitationA qualitative study of women with obesity in general practice reported that many participants denied being treated differently because of their weight and did not believe they received less care.
“Contrary to these results, a qualitative study conducted with women with obesity in a general practice setting reported that many participants denied being treated differently because of their weight and did not believe that they received less care (Buxton and Snethen, 2013).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Buxton and Snethen, 2013
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
FindingcitationA greater BMI predicted greater weight bias internalization and greater health care utilization.
“Hilbert et al. reported that a greater BMI predicted greater weight bias internalization and greater health care utilization (Hilbert et al., 2014).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Hilbert et al., 2014
Not checked in the free run.
May combine two claims.
PremisecitationStigmatizing attitudes from health professionals are perceived and received by individuals with obesity and may contribute to multiple barriers to health care utilization.
“These stigmatizing attitudes are perceived and received by individuals with obesity and may contribute to the creation of multiple barriers to health care utilization”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Drury and Louis, 2002
Not checked in the free run.
May combine two claims.
PremisecitationOver the past decade, the prevalence of weight bias increased in the United States by 66% and has been documented in employment, education, and health care settings.
“Over the past decade, the prevalence of weight bias has increased in the United States by 66% and has been documented in employment, education, and health care settings”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites Andreyeva et al., 2008
Not checked in the free run.
- cites Puhl and Heuer, 2009
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataFour independent reviewers screened titles and abstracts using keywords and their synonyms.
“Four independent reviewers screened titles and abstracts using the following keywords and their synonyms: weight bias, primary health care, and use of health care services.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenAll reviewers verified the charted data for accuracy and completeness.
“All reviewers verified the data for accuracy and completeness.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationWeight bias was cited as the fourth most common form of discrimination among US adults.
“Weight bias was cited as the fourth most common form of discrimination among US adults”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Puhl et al., 2008
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenDiscrepancies between reviewers were resolved by consensus.
“Discrepancies were resolved by consensus between reviewers.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductcitationThe Preferred Reporting Items for Systematic Review and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) was used to guide the reporting for this scoping review.
“The Preferred Reporting Items for Systematic Review and Meta-Analyses extension for Scoping Reviews (PRISMA- ScR) was used to guide the reporting for this scoping review”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Tricco et al., 2018
Not checked in the free run.
May combine two claims.
PremisecitationWeight bias poses adverse mental and physical health consequences such as exercise avoidance, anxiety, low self-esteem, and depression.
“Not only does weight bias pose adverse mental and physical health consequences such as exercise avoidance (Vartanian and Shaprow, 2008), anxiety (Hilbert et al., 2014), low self-esteem (Hilbert et al., 2014), and depression (Hilbert et al., 2014)”
Quote in the paperSubstantial claim0 of 2 sources checked- cites Vartanian and Shaprow, 2008
Not checked in the free run.
- cites Hilbert et al., 2014
Not checked in the free run.
May combine two claims.
InterpretationreasoningWeight bias negatively affects patients' engagement in primary health care through their perceived barriers to health care utilization, expectations of differential health care treatment, low trust and poor communication, avoidance or delay of health services, and 'doctor shopping'.
“Second, it is clear that weight bias negatively affects patients’ engagement in primary health care through their perceived barriers to health care utilization, expectations of differential health care treatment, low trust and poor communication, avoidance or delay of health services, and ‘doctor shopping’.”
Quote in the paperSubstantial claim- Rests on an assumption: Patients' self-reported perceptions of weight bias accurately reflect health professionals' actual weight bias.
- Rests on an assumption: The association between weight bias and avoidance or delay of health care is causal.
The paper relies on this without support.
Patients' self-reported perceptions of weight bias accurately reflect health professionals' actual weight bias.
“Patients with overweight and obesity who felt their primary care providers judged their weight were less likely to report high trust in these primary care practitioners (Gudzune et al., 2014a).”
The paper relies on this without support.
The included studies are sufficiently methodologically sound and comparable to synthesize into themes and conclusions.
“In this scoping review, we reviewed 21 published studies to examine the influence of weight bias on engagement in primary health care.”
The paper relies on this without support.
The association between weight bias and avoidance or delay of health care is causal.
“The results of this review indicate that patients with overweight and obesity delay or avoid health care services as a result of health professionals’ weight bias.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Perceptions and/or experiences of weight bias in primary care settings negatively influence patient engagement with health care services.
“Perceptions and/or experiences of weight bias in primary care settings have been shown to negatively influence patient engagement with health care services [210].”
From Food Addiction and Psychosocial Adversity: Biological Embedding, Contextual Factors, and Public Health Implications (2020) · cites this paper as [210]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Forhan participant counts do not add to the stated sample size
MinorThe reported male and female counts total 10, but the study's sample size is given as 11. The table does not account for the remaining participant.
Reported 11 · recomputed 10
“N = 11(M = 2, F = 8) 19–64 years old registered with a primary care practice”
Drury and Louis BMI counts leave six participants unaccounted for
MinorThe four reported BMI-group counts total 210, whereas the stated sample size is 216.
Reported 216 · recomputed 210
“N = 216 women from church sites 30–59 years old | Normal <27.5 kg/m2 (n = 137), mild obesity 27.5–30.0 kg/m2 (n = 19), moderate obesity >30–40 kg/m2 (n = 43), morbid obesity >40 kg/m2 (n = 11)”
Hansson and Rasmussen BMI counts leave 160 participants unaccounted for
MinorThe three reported BMI-group counts total 2,628, not the stated sample size of 2,788.
Reported 2788 · recomputed 2628
“N = 2788 adults aged 25–64 years in 2008 | Normal weight (n = 1064), moderate obesity (n = 1273), and severe obesity (n = 291) at the time of participation in the ULF survey”
Underweight and normal-weight BMI definitions overlap
MinorThe table defines underweight as a BMI greater than 20 kg/m2, which includes the entire stated normal-weight range of 20-24.9 kg/m2. The two classifications therefore cannot be distinct as written.
“Underweight >20 kg/m2”
“normal weight 20–24.9 kg/m2”
Cites
PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation
Tricco, A. C., Lillie, E., Zarin, W., O'Brien, K. K., Colquhoun, H., Levac, D., Moher, D., Peters, M. D. J., Horsley, T., Weeks, L., et al. (2018) · Annals of Internal Medicine · doi:10.7326/m18-0850 · Cited by 43,565 · see citing works
Scoping studies: towards a methodological framework
Arksey, H., & O'Malley, L. (2005) · International Journal of Social Research Methodology · doi:10.1080/1364557032000119616 · Cited by 36,742 · see citing works
Lippa, N. C., & Sanderson, S. C. (2013) · Human Heredity · doi:10.1159/000353712 · Cited by 6,093 · see citing works
The Stigma of Obesity: A Review and Update
Puhl, R. M., & Heuer, C. A. (2009) · Obesity · doi:10.1038/oby.2008.636 · Cited by 3,323 · cited 2× · see citing works
“Weight bias and stigma, known as negative, prejudicial, or stereotypical beliefs and attitudes toward individuals based on their size, has been identified as a barrier to seeking health care services (Drury and Louis, 2002; Puhl and Heuer, 2009; Washington, 2011).”
BackgroundImpact of weight bias and stigma on quality of care and outcomes for patients with obesity
Phelan, S. M., Burgess, D. J., Yeazel, M. W., Hellerstedt, W. L., Griffin, J. M., & van Ryn, M. (2015) · Obesity Reviews · doi:10.1111/obr.12266 · Cited by 1,361 · see citing works
Puhl, R. M., Andreyeva, T., & Brownell, K. D. (2008) · International Journal of Obesity · doi:10.1038/ijo.2008.22 · Cited by 900 · see citing works
Changes in Perceived Weight Discrimination Among Americans, 1995–1996 Through 2004–2006
Andreyeva, T., Puhl, R., & Brownell, K. (2008) · Obesity · doi:10.1038/oby.2008.35 · Cited by 686 · see citing works
Implicit anti-fat bias among health professionals: is anyone immune?
Teachman, B., & Kd, B. (2001) · International Journal of Obesity · doi:10.1038/sj.ijo.0801745 · Cited by 598 · see citing works
Barriers to routine gynecological cancer screening for White and African-American obese women
Amy, N. K., Aalborg, A. E., Lyons, P., & Keränen, L. (2005) · International Journal of Obesity · doi:10.1038/sj.ijo.0803105 · Cited by 422 · see citing works
Effects of Weight Stigma on Exercise Motivation and Behavior
Vartanian, L. R., & Shaprow, J. G. (2007) · Journal of Health Psychology · doi:10.1177/1359105307084318 · Cited by 401 · see citing works
Exploring the Association Between Body Weight, Stigma of Obesity, and Health Care Avoidance
Drury, C. A. A., & Louis, M. (2002) · Journal of the American Academy of Nurse Practitioners · doi:10.1111/j.1745-7599.2002.tb00089.x · Cited by 388 · see citing works
Motivating or stigmatizing? Public perceptions of weight-related language used by health providers
Puhl, R. M., Peterson, J. L., & Luedicke, J. (2012) · International Journal of Obesity · doi:10.1038/ijo.2012.110 · Cited by 287 · see citing works
Obesity: assessment and management in primary care.
Lyznicki, J. M., Young, D., Riggs, J. A., & Davis, R. (2001) · PubMed · Cited by 274 · see citing works
Weight bias reduction in health professionals: a systematic review
Alberga, A. S., Pickering, B., Hayden, A., Ball, G. D. C., Edwards, A. L., Jelinski, S. E., Nutter, S., Oddie, S., Sharma, A. M., & Russell‐Mayhew, S. (2016) · Clinical Obesity · doi:10.1111/cob.12147 · Cited by 240 · see citing works
Self-citationObesity: Understanding and treating a serious, prevalent, and refractory disorder.
Brownell, K. D. (1982) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.50.6.820 · Cited by 216 · see citing works
Body weight and health care among women in the general population.
Fontaine, K. R., Faith, M., Allison, D. B., & Cheskin, L. J. (1998) · Archives of Family Medicine · doi:10.1001/archfami.7.4.381 · Cited by 200 · see citing works
Obese Women's Perceptions of Their Physicians' Weight Management Attitudes and Practices
Wadden, T. A. (2000) · Archives of Family Medicine · doi:10.1001/archfami.9.9.854 · Cited by 178 · see citing works
Primary care support for tackling obesity: a qualitative study of the perceptions of obese patients.
Brown, I., Thompson, J. L., Tod, A., & Jones, G. L. (2006) · Europe PMC (PubMed Central) · Cited by 177 · see citing works
Weight bias internalization, core self‐evaluation, and health in overweight and obese persons
Hilbert, A., Brähler, E., Häuser, W., & Zenger, M. (2013) · Obesity · doi:10.1002/oby.20561 · Cited by 173 · see citing works
Physicians build less rapport with obese patients
Gudzune, K. A., Beach, M. C., Roter, D. L., & Cooper, L. A. (2013) · Obesity · doi:10.1002/oby.20384 · Cited by 171 · see citing works
Obesity: Understanding and treating a serious, prevalent, and refractory disorder.
Brownell, K. D. (1982) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.50.6.820 · Cited by 171 · see citing works
Overweight women delay medical care
Olson, C. (1994) · Archives of Family Medicine · doi:10.1001/archfami.3.10.888 · Cited by 155 · see citing works
The Relationship of Obesity to the Frequency of Pelvic examinations
Adams, C. H., Smith, N. J., Wilbur, D. C., & Grady, K. E. (1993) · Women & Health · doi:10.1300/j013v20n02_04 · Cited by 151 · see citing works
Women’s stories of their experiences as overweight patients
Merrill, E., & Grassley, J. S. (2008) · Journal of Advanced Nursing · doi:10.1111/j.1365-2648.2008.04794.x · Cited by 149 · see citing works
A Study of Discrimination within the Medical Community as Viewed by Obese Patients
Kaminsky, J., & Gadaleta, D. J. (2002) · Obesity Surgery · doi:10.1381/096089202321144513 · Cited by 140 · see citing works
The Impact of Obesity on Gynecologic Cancer Screening: An Integrative Literature Review
Aldrich, T., & Hackley, B. K. (2010) · Journal of Midwifery & Women s Health · doi:10.1016/j.jmwh.2009.10.001 · Cited by 122 · see citing works
Patients who feel judged about their weight have lower trust in their primary care providers
Gudzune, K., Bennett, W. L., Cooper, L., & Bleich, S. (2014) · Patient Education and Counseling · doi:10.1016/j.pec.2014.06.019 · Cited by 122 · see citing works
Cancer Screening in WomenBody Mass Index and Adherence to Physician Recommendations
Ferrante, J. M., CHEN, P., Crabtree, B. F., & Wartenberg, D. E. (2007) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2007.02.004 · Cited by 104 · see citing works
Weight Bias and Weight Loss Treatment Outcomes in Treatment-Seeking Adults
Carels, R. A., Young, K. M., Wott, C. B., Harper, J., Gumble, A., Oehlhof, M. W., & Clayton, A. M. (2009) · Annals of Behavioral Medicine · doi:10.1007/s12160-009-9109-4 · Cited by 99 · see citing works
Rueda‐Clausen, C. F., Benterud, E., Bond, T. R., Olszowka, R., Vallis, M. T., & Sharma, A. M. (2013) · Clinical Obesity · doi:10.1111/cob.12038 · Cited by 83 · see citing works
Nonadherence to breast and cervical cancer screening: what are the linkages to chronic disease risk?
Coughlin, S. S., Uhler, R. J., Hall, H. I., & Briss, P. A. (2004) · Europe PMC (PubMed Central) · Cited by 68 · see citing works
DeJoy, S. B., Bittner, K., & Mandel, D. (2016) · Journal of Midwifery & Women s Health · doi:10.1111/jmwh.12375 · Cited by 57 · see citing works
Childhood obesity: issues of weight bias.
Washington, R. (2011) · PubMed · Cited by 54 · see citing works
Contributors to patient engagement in primary health care: perceptions of patients with obesity
Forhan, M. A., Risdon, C., & Solomon, P. E. (2012) · Primary Health Care Research & Development · doi:10.1017/s1463423612000643 · Cited by 50 · see citing works
Self-citationObese Women’s Perceptions and Experiences of Healthcare and Primary Care Providers
Buxton, B. K., & Snethen, J. (2013) · Nursing Research · doi:10.1097/nnr.0b013e318299a6ba · Cited by 44 · see citing works
Impact of perceived weight stigma among underserved women on doctor–patient relationships
Ferrante, J. M., Seaman, K., Bator, A., Ohman‐Strickland, P., Gundersen, D. A., Clemow, L., & Puhl, R. M. (2016) · Obesity Science & Practice · doi:10.1002/osp4.40 · Cited by 40 · see citing works
Living large: the experiences of large-bodied women when accessing general practice services
Russell, N., & Carryer, J. (2013) · Journal of Primary Health Care · doi:10.1071/hc13199 · Cited by 36 · see citing works
Future research in weight bias: What next?
Alberga, A., Russell-Mayhew, S., von Ranson, K. V., McLaren, L., Salas, X. R., & Sharma, A. M. (2016) · Obesity · doi:10.1002/oby.21480 · Cited by 29 · see citing works
Self-citationGudzune, K., Bennett, W. L., Cooper, L., Clark, J., & Bleich, S. (2014) · Obesity · doi:10.1002/oby.20808 · Cited by 17 · see citing works
Obese older adults report high satisfaction and positive experiences with care
Bottone, F. G., Musich, S. A., Wang, S. S., Hommer, C. E., Yeh, C. S., & Hawkins, K. (2014) · BMC Health Services Research · doi:10.1186/1472-6963-14-220 · Cited by 15 · see citing works
Association Between Perceived Health Care Stigmatization and BMI Change
Hansson, L. M., & Rasmussen, F. E. (2014) · Obesity Facts · doi:10.1159/000363557 · Cited by 14 · see citing works
Peer Reviewed: Childhood Obesity: Issues of Weight Bias
Washington, R. (2011) · Preventing Chronic Disease · Cited by 6 · see citing works
The health care disadvantages of being obese
Prior, W. (2002) · New South Wales Public Health Bulletin · doi:10.1071/nb02066 · Cited by 5 · see citing works
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Sorted by citations
Obesity in adults: a clinical practice guideline
Wharton, S., Lau, D. C. W., Vallis, M., Sharma, A. M., Biertho, L., Campbell-Scherer, D., Adamo, K., Alberga, A., Bell, R., Boulé, N., et al. (2020) · Canadian Medical Association Journal · doi:10.1503/cmaj.191707 · Cited by 1,506 · see citing works
Self-citationJoint international consensus statement for ending stigma of obesity
Rubino, F., Puhl, R. M., Cummings, D. E., Eckel, R. H., Ryan, D. H., Mechanick, J. I., Nadglowski, J., Ramos Salas, X., Schauer, P. R., Twenefour, D., et al. (2020) · Nature Medicine · doi:10.1038/s41591-020-0803-x · Cited by 1,152 · see citing works
Obesity Stigma: Causes, Consequences, and Potential Solutions
Westbury, S., Oyebode, O., van Rens, T., & Barber, T. M. (2023) · Current Obesity Reports · doi:10.1007/s13679-023-00495-3 · Cited by 317 · see citing works
Weight bias among health care professionals: A systematic review and meta‐analysis
Lawrence, B. J., Kerr, D., Pollard, C. M., Theophilus, M., Alexander, E., Haywood, D., & O’Connor, M. (2021) · Obesity · doi:10.1002/oby.23266 · Cited by 283 · see citing works
Effective strategies in ending weight stigma in healthcare
Talumaa, B., Brown, A., Batterham, R. L., & Kalea, A. Z. (2022) · Obesity Reviews · doi:10.1111/obr.13494 · Cited by 250 · see citing works
Aghili, S. M. M., Ebrahimpur, M., Arjmand, B., Shadman, Z., Sani, M. P., Qorbani, M., Larijani, B. A., & Payab, M. (2021) · International Journal of Obesity · doi:10.1038/s41366-021-00776-8 · Cited by 236 · see citing works
Obesity II: Establishing causal links between chemical exposures and obesity
Heindel, J. J., Howard, S. G., Agay‐Shay, K., Arrebola, J. P., Audouze, K., Babin, P. J., Barouki, R., Bansal, A., Blanc, É., Cave, M. C., et al. (2022) · Biochemical Pharmacology · doi:10.1016/j.bcp.2022.115015 · Cited by 201 · see citing works
Ryan, L., Coyne, R., Heary, C., Birney, S., Crotty, M., Dunne, R., Conlan, O., & Walsh, J. C. (2023) · Obesity Reviews · doi:10.1111/obr.13606 · Cited by 149 · see citing works
Cardel, M. I., Newsome, F. A., Pearl, R. L., Ross, K. M., Dillard, J. R., Miller, D. R., Hayes, J. F., Wilfley, D. E., Keel, P. K., Dhurandhar, E. J., et al. (2022) · Journal of the Academy of Nutrition and Dietetics · doi:10.1016/j.jand.2022.01.004 · Cited by 118 · see citing works
Morgan-Bathke, M., Raynor, H. A., Baxter, S. D., Halliday, T. M., Lynch, A., Malik, N., Garay, J. L., & Rozga, M. (2023) · Journal of the Academy of Nutrition and Dietetics · doi:10.1016/j.jand.2022.11.014 · Cited by 85 · see citing works
European Association for the Study of Obesity Position Statement on the Global COVID-19 Pandemic
Frühbeck, G., Baker, J. L., Busetto, G. M., Dicker, D., Goossens, G. H., Halford, J. C. G., Handjieva‐Darlenska, T., Hassapidou, M. N., Holm, J., Lehtinen‐Jacks, S., et al. (2020) · Obesity Facts · doi:10.1159/000508082 · Cited by 85 · see citing works
Obesity in Adults: A 2022 Adapted Clinical Practice Guideline for Ireland
Breen, C., O’Connell, J., Geoghegan, J., O'Shea, D. B., Birney, S., Tully, L., Gaynor, K., O’Kelly, M., O’Malley, G., O’Donovan, C. B., et al. (2022) · Obesity Facts · doi:10.1159/000527131 · Cited by 77 · see citing works
Moore, C. H., Oliver, T. L., Randolph, J., & Dowdell, E. B. (2022) · Clinical Obesity · doi:10.1111/cob.12545 · Cited by 74 · see citing works
Obesity and COVID-19: The Two Sides of the Coin
Dicker, D., Bettini, S., Farpour‐Lambert, N. J., Frühbeck, G., Golan, R., Goossens, G. H., Halford, J. C. G., O’Malley, G., Müllerová, D., Salas, X. R., et al. (2020) · Obesity Facts · doi:10.1159/000510005 · Cited by 69 · see citing works
The impact of obesity on reproductive health and metabolism in reproductive-age females
Schon, S. B., Cabre, H. E., & Redman, L. M. (2024) · Fertility and Sterility · doi:10.1016/j.fertnstert.2024.04.036 · Cited by 68 · see citing works
Wiss, D. A., Avena, N., & Gold, M. (2020) · Nutrients · doi:10.3390/nu12113521 · Cited by 66 · see citing works
Fruh, S., Graves, R., Hauff, C., Williams, S. G., & Hall, H. R. (2021) · Nursing Clinics of North America · doi:10.1016/j.cnur.2021.07.001 · Cited by 65 · see citing works
Barazzoni, R., Bischoff, S. C., Busetto, L., Cederholm, T., Chourdakis, M., Cuerda, C., Delzenne, N. M., Genton, L., Schneider, S. M., Singer, P., et al. (2021) · Clinical Nutrition · doi:10.1016/j.clnu.2021.05.006 · Cited by 59 · see citing works
Dicker, D., Alfadda, A. A., Coutinho, W., Cuevas, A., Halford, J. C. G., Hughes, C. A., Iwabu, M., Kang, J.-H., Nawar, R., Reynoso, R., et al. (2021) · European Journal of Internal Medicine · doi:10.1016/j.ejim.2021.01.019 · Cited by 56 · see citing works
Rubino, D., Bjorner, J. B., Rathor, N., Sharma, A. M., von Huth Smith, L., Wharton, S., Wadden, T., Zeuthen, N., & Kolotkin, R. L. (2024) · Diabetes, Obesity and Metabolism · doi:10.1111/dom.15620 · Cited by 56 · see citing works
Heer, E. V., Peters, C., Knight, R., Yang, L., & Heitman, S. J. (2023) · Preventive Medicine · doi:10.1016/j.ypmed.2023.107478 · Cited by 54 · see citing works
Time to end weight stigma in healthcare
Flint, S. W. (2021) · EClinicalMedicine · doi:10.1016/j.eclinm.2021.100810 · Cited by 51 · see citing works
Use and Misuse of BMI Categories
Flegal, K. M. (2023) · The AMA Journal of Ethic · doi:10.1001/amajethics.2023.550 · Cited by 53 · see citing works
Caring for US Children: Barriers to Effective Treatment in Children with the Disease of Obesity
Srivastava, G., Browne, N. T., Kyle, T. K., O’Hara, V. M., Browne, A. F., Nelson, T., & Puhl, R. M. (2020) · Obesity · doi:10.1002/oby.22987 · Cited by 48 · see citing works
A qualitative exploration of obesity bias and stigma in Irish healthcare; the patients’ voice
O’Donoghue, G., Cunningham, C., King, M., O’Keefe, C., Rofaeil, A., & McMahon, S. (2021) · PLoS ONE · doi:10.1371/journal.pone.0260075 · Cited by 47 · see citing works
ESI Clinical Practice Guidelines for the Evaluation and Management of Obesity In India
Madhu, S., Kapoor, N., Das, S., Nishant, R., & Sanjay, K. (2022) · Indian Journal of Endocrinology and Metabolism · doi:10.4103/2230-8210.356236 · Cited by 46 · see citing works
Effect of lockdown for COVID-19 on self-reported body weight gain in a sample of obese patients
de Luis, D. A., Izaola, O., Martín, D. P., Hoyos, E. G., Torres, B., & Gómez, J. J. L. (2020) · Nutrición Hospitalaria · doi:10.20960/nh.03307 · Cited by 43 · see citing works
Stigmatizing weight experiences in health care: Associations with BMI and eating behaviours
Remmert, J. E., Convertino, A. D., Roberts, S. R., Godfrey, K. M., & Butryn, M. L. (2019) · Obesity Science & Practice · doi:10.1002/osp4.379 · Cited by 43 · see citing works
Gorlick, J., Gorman, C. V., Weeks, H. M., Pearlman, A. T., Schvey, N. A., & Bauer, K. W. (2020) · Childhood Obesity · doi:10.1089/chi.2020.0199 · Cited by 43 · see citing works
Anatomy's missing faces: An assessment of representation gaps in atlas and textbook imagery
Beresheim, A. C., Zepeda, D., Pharel, M., Soy, T., Wilson, A. B., & Ferrigno, C. (2024) · Anatomical Sciences Education · doi:10.1002/ase.2432 · Cited by 40 · see citing works
Joint international consensus statement for ending stigma of obesity
Rubino, F., Puhl, R. M., De, C., Eckel, R. H., Ryan, D. H., Ji, M., Nadglowski, J. F., Salas, X. R., Schauer, P. R., Twenefour, D., et al. (2020) · Yearbook of pediatric endocrinology · doi:10.1530/ey.17.11.16 · Cited by 40 · see citing works
Weight stigma and bias: standards of care in overweight and obesity—2025
Bannuru, R. R. (2025) · BMJ Open Diabetes Research & Care · doi:10.1136/bmjdrc-2025-004962 · Cited by 44 · see citing works
Body image and interest in GLP-1 weight loss medications
Markey, C. N., August, K. J., Malik, D., & Richeson, A. L. (2025) · Body Image · doi:10.1016/j.bodyim.2025.101890 · Cited by 34 · see citing works
Obesity stigma and its impact on health: A narrative review
Sánchez‐Carracedo, D. (2022) · Endocrinología Diabetes y Nutrición (English ed ) · doi:10.1016/j.endien.2021.12.007 · Cited by 33 · see citing works
Sutin, A. R., Robinson, E., Daly, M., Gerend, M. A., Stéphan, Y., Luchetti, M., Aschwanden, D., Strickhouser, J. E., Lee, J. H., Sesker, A. A., et al. (2020) · Obesity · doi:10.1002/oby.22914 · Cited by 33 · see citing works
Hailu, H., Skouteris, H., Rodriguez, A. C. I., Galvin, E., & Hill, B. (2024) · Obesity Reviews · doi:10.1111/obr.13710 · Cited by 32 · see citing works
Experiences of weight stigma in adolescents with severe obesity and their families
Roberts, K. J., Polfuss, M. L., Marston, E. C., & Davis, R. L. (2021) · Journal of Advanced Nursing · doi:10.1111/jan.15012 · Cited by 30 · see citing works
Townsend, M. J., Kyle, T. K., & Stanford, F. C. (2020) · Metabolism · doi:10.1016/j.metabol.2020.154316 · Cited by 30 · see citing works
Weight bias reduction among first‐year medical students: A quasi‐randomized, controlled trial
Fitterman-Harris, H. F., & Wal, J. S. V. (2021) · Clinical Obesity · doi:10.1111/cob.12479 · Cited by 29 · see citing works
Weight stigma in the COVID-19 pandemic: a scoping review
de Macêdo, P. F. C., Nepomuceno, C. M. M., dos Santos, N. S., Queiroz, V. A. D. O., Pereira, E. M., Leal, L. D. C., Santos, L. A. D. S., Nascimento, L. F., Martins, P. C., & de Santana, M. L. P. (2022) · Journal of Eating Disorders · doi:10.1186/s40337-022-00563-4 · Cited by 29 · see citing works
How Weight Bias and Stigma Undermine Healthcare Access and Utilization
Pearl, R. L., & Sheynblyum, M. (2025) · Current Obesity Reports · doi:10.1007/s13679-025-00605-3 · Cited by 28 · see citing works
Charalambous, A., Pincus, D., High, S., Leung, F., Aktar, S., Paterson, J. M., Redelmeier, D. A., & Ravi, B. (2021) · JAMA Network Open · doi:10.1001/jamanetworkopen.2021.23478 · Cited by 28 · see citing works
Taylor, K., Indulkar, T., Thompson, B., Pinkard, C., Barron, E., Frost, T., Jayawardane, P., Davies, N., Bakhai, C., Forouhi, N. G., et al. (2024) · Obesity · doi:10.1002/oby.24024 · Cited by 27 · see citing works
Predictors of Weight Bias in Exercise Science Students and Fitness Professionals: A Scoping Review
Zaroubi, L., Samaan, T., & Alberga, A. S. (2021) · Journal of Obesity · doi:10.1155/2021/5597452 · Cited by 27 · see citing works
Self-citationSand, F. L., Urbutė, A., Ring, L. L., Kjær, A. K., Belmonte, F., & Kjær, S. K. (2023) · Preventive Medicine · doi:10.1016/j.ypmed.2023.107519 · Cited by 26 · see citing works
Weight Stigma in Latin America, Asia, the Middle East, and Africa: A Scoping Review
Eggerichs, L. A., Wilson, O. W. A., Chaplin, J. E., & Ramos Salas, X. (2024) · Obesity Facts · doi:10.1159/000536554 · Cited by 24 · see citing works
El estigma de la obesidad y su impacto en la salud: una revisión narrativa
Sánchez‐Carracedo, D. (2022) · Endocrinología Diabetes y Nutrición · doi:10.1016/j.endinu.2021.12.002 · Cited by 24 · see citing works
Weight bias and stigma in healthcare professionals: a narrative review with a Singapore lens
Goff, A. J., Lee, Y., & Tham, K. W. (2023) · Singapore Medical Journal · doi:10.4103/singaporemedj.smj-2022-229 · Cited by 24 · see citing works
Obesity in adults: Clinical practice guideline adapted for Chile
de la Obesidad, C. C. P. E. E., & Contreras, Y. P. (2022) · Medwave · doi:10.5867/medwave.2022.10.2649 · Cited by 23 · see citing works
Jayawickrama, R. S., Hill, B., O’Connor, M., Flint, S. W., Hemmingsson, E., Ellis, L. R., Du, Y., & Lawrence, B. J. (2024) · Obesity Reviews · doi:10.1111/obr.13847 · Cited by 26 · see citing works
Kendrick, K. N., Bode Padron, K. J., Bomani, N. Z., German, J. C., Nyanyo, D. D., Varriano, B., Tu, L., & Stanford, F. C. (2023) · Endocrinology and Metabolism Clinics of North America · doi:10.1016/j.ecl.2023.05.003 · Cited by 21 · see citing works
Mitigating Weight Bias in the Clinical Setting: A New Approach to Care
Olson, S., Muñoz, E. G., Solis, E., & Bradford, H. M. (2023) · Journal of Midwifery & Women s Health · doi:10.1111/jmwh.13578 · Cited by 22 · see citing works
Missed diagnosis—a major barrier to patient access to obesity healthcare in the primary care setting
Meron, M. K., Eizenstein, S., Cukierman‐Yaffe, T., & Oieru, D. (2024) · International Journal of Obesity · doi:10.1038/s41366-024-01514-6 · Cited by 21 · see citing works
Arena, R. A., MYERS, J. N., Kaminsky, L. A., Williams, M. A., Sabbahi, A., Popović, D., Axtell, R. S., Faghy, M. A., Hills, A. P., Olivares, S. L. O., et al. (2021) · Current Problems in Cardiology · doi:10.1016/j.cpcardiol.2021.100823 · Cited by 21 · see citing works
Fat embodiment for resistance and healing from weight stigma
Sturgess, C. M. B., & Stinson, D. A. (2022) · Body Image · doi:10.1016/j.bodyim.2022.02.007 · Cited by 21 · see citing works
Weight-Inclusive Approaches to Nutrition and Dietetics: A Needed Paradigm Shift
Levinson, J. A., Clifford, D. E., Laing, E. M., Harris, C., Slagel, N., Squires, N. D., & Hunger, J. M. (2024) · Journal of Nutrition Education and Behavior · doi:10.1016/j.jneb.2024.07.007 · Cited by 21 · see citing works
Ryan, L., Quigley, F., Birney, S., Crotty, M., Conlan, O., & Walsh, J. C. (2024) · Health Expectations · doi:10.1111/hex.14098 · Cited by 19 · see citing works
Patient Perceptions of Weight Stigma Experiences in Healthcare: A Qualitative Analysis
Robinson, K. M., Robinson, K. A., Scherer, A. M., & Mackin, M. L. (2024) · Health Expectations · doi:10.1111/hex.70013 · Cited by 18 · see citing works
Newsome, F. A., Gravlee, C. C., & Cardel, M. I. (2021) · Nursing Clinics of North America · doi:10.1016/j.cnur.2021.07.003 · Cited by 18 · see citing works
Comparisons of Explicit Weight Bias Across Common Clinical Specialties of US Resident Physicians
Philip, S. R., Fields, S. A., van Ryn, M., & Phelan, S. M. (2023) · Journal of General Internal Medicine · doi:10.1007/s11606-023-08433-8 · Cited by 18 · see citing works
Baska, A., Swider, K. J., Zgliczyński, W. S., Kłoda, K., Mastalerz–Migas, A., & Babicki, M. (2024) · Nutrients · doi:10.3390/nu16070999 · Cited by 16 · see citing works
Joseph, E. C., & Raque‐Bogdan, T. L. (2023) · Mindfulness · doi:10.1007/s12671-023-02094-8 · Cited by 15 · see citing works
O’Donoghue, G., McMahon, S., Holt, A., Nedai, M., Nybo, T., & Peiris, C. L. (2021) · Physiotherapy · doi:10.1016/j.physio.2021.03.016 · Cited by 15 · see citing works
Czepczor‐Bernat, K., Zembura, M., & Matusik, P. (2025) · Nutrients · doi:10.3390/nu17111763 · Cited by 14 · see citing works
Robins, A., Jenkinson, B., & Kearney, L. N. (2025) · Midwifery · doi:10.1016/j.midw.2025.104444 · Cited by 14 · see citing works
Social desirability bias is related to children's energy intake in a laboratory test meal paradigm
Kelly, N. R., Doty, K. J., Guidinger, C., Folger, A. C., Luther, G. M., & Giuliani, N. R. (2024) · Appetite · doi:10.1016/j.appet.2024.107235 · Cited by 15 · see citing works
Reducing weight bias and stigma in qualitative research interviews: Considerations for researchers
Hung, P., Miciak, M., Godziuk, K., Gross, D. P., & Forhan, M. A. (2024) · Obesity Reviews · doi:10.1111/obr.13750 · Cited by 13 · see citing works
Self-citationWomen’s refusal to be weighed during healthcare visits: Links to body image
Winter, V. R., Trout, K. E., Harrop, E. N., O’Neill, E. A., Puhl, R. M., & Bartlett‐Esquilant, G. (2023) · Body Image · doi:10.1016/j.bodyim.2023.04.006 · Cited by 12 · see citing works
Heidebrecht, C., Fierheller, D., Martel, S. L., Andrews, A., Hollahan, A., Griffin, L., Meerai, S., Lock, R., Nabavian, H., D’Silva, C., et al. (2024) · BMC Medical Education · doi:10.1186/s12909-023-04889-8 · Cited by 12 · see citing works
de Luis, D. A., Izaola, O., Primo, D., Hoyos, E. G., Torres, B., Gómez, J. J. L., & Pacheco, D. (2021) · Obesity Surgery · doi:10.1007/s11695-021-05253-9 · Cited by 12 · see citing works
Reach of a Fully Digital Diabetes Prevention Program in Health Professional Shortage Areas
Auster‐Gussman, L. A., Lockwood, K. G., Graham, S. A., Stein, N., & Branch, O. H. (2022) · Population Health Management · doi:10.1089/pop.2021.0283 · Cited by 12 · see citing works
Obesity and Eligibility for Obesity Treatments Among Adults With Disabilities in the U.S.
Townsend, M. J., Claridy, M. D., Bajaj, S. S., Tu, L., & Stanford, F. C. (2022) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2022.04.003 · Cited by 12 · see citing works
Spanish validation of the Modified Weight Bias Internalization Scale (WBIS-M) for adolescents
Andrés, A., Fornieles-Deu, A., Sepúlveda, A. R., Beltrán‐Garrayo, L., Montcada-Ribera, A., Bach-Faig, A., & Sánchez‐Carracedo, D. (2022) · Eating and Weight Disorders - Studies on Anorexia Bulimia and Obesity · doi:10.1007/s40519-022-01453-z · Cited by 14 · see citing works
Koetsier, L., van den Eynde, E., van Mil, E., van der Velde, M., de Vries, R., Baan, C. A., Seidell, J. C., & Halberstadt, J. (2023) · BMC Health Services Research · doi:10.1186/s12913-022-08957-5 · Cited by 12 · see citing works
Changes in weight bias after simulation in pre-license baccalaureate nursing students
Llewellyn, S., Connor, K., Quatraro, M., & Dye, J. H. (2022) · Teaching and learning in nursing · doi:10.1016/j.teln.2022.07.006 · Cited by 11 · see citing works
Braley, K., Richardson, K., Whitley, L., Werner, K., & Appleby, L. (2023) · Pulmonary Circulation · doi:10.1002/pul2.12247 · Cited by 11 · see citing works
Self‐perception of aging and perceived medical discrimination
Sun, N., Xu, Z., Hua, C. L., Qiu, X. H., Pittman, A., Abdou, B., & Brown, J. S. (2023) · Journal of the American Geriatrics Society · doi:10.1111/jgs.18517 · Cited by 11 · see citing works
Gunsalus, K. T. W., Mixon, J. K., & House, E. M. (2024) · Medical Science Educator · doi:10.1007/s40670-024-02025-9 · Cited by 14 · see citing works
Charnley, M., Newson, L., Weeks, A. D., & Abayomi, J. C. (2024) · PLoS ONE · doi:10.1371/journal.pone.0302599 · Cited by 11 · see citing works
Weight Bias Interventions for Healthcare Professionals: An Integrative Review
Marler, G. S., Turk, M. T., Kalarchian, M. A., Oermann, M. H., Sabol, V. K., & Phelan, S. M. (2025) · Journal of Advanced Nursing · doi:10.1111/jan.17065 · Cited by 11 · see citing works
Dagan, S. S., Kessler, Y., Mardy-Tilbor, L., Raziel, A., Sakran, N., Boaz, M., & Shriqui, V. K. (2022) · Obesity Facts · doi:10.1159/000521856 · Cited by 11 · see citing works
Effect of Overweight and Obesity on Periodontal Treatment Intensity
Krall, E. A., McDonough, R., Singhal, A., García, R. I., & Jurasic, M. M. (2022) · JDR Clinical & Translational Research · doi:10.1177/23800844221074354 · Cited by 11 · see citing works
Understanding Disordered Eating Risks in Patients with Gastrointestinal Conditions
Riehl, M. E., & Scarlata, K. (2021) · Journal of the Academy of Nutrition and Dietetics · doi:10.1016/j.jand.2021.03.001 · Cited by 14 · see citing works
Lindberg, C. S., Sandbæk, A., Jensen, S. D., Bruun, J. M., & Andreassen, P. (2023) · Obesity Science & Practice · doi:10.1002/osp4.669 · Cited by 10 · see citing works
Curran, F., Brennan, C., Matthews, J. J., & O’Donoghue, G. (2023) · Obesity Science & Practice · doi:10.1002/osp4.721 · Cited by 9 · see citing works
Patient perspectives of weight stigma across the cancer continuum: A scoping review
Hawley, N. A., Green, J., Ahlich, E. M., Hauff, C., Hermer, J., Skiba, M. B., James, D. L., & Nash, S. H. (2024) · Cancer Medicine · doi:10.1002/cam4.6882 · Cited by 10 · see citing works
Accommodating patients with obesity in ambulatory care: A clinical environment checklist
Boland, W., Li, W. S., & Dilly, C. K. (2024) · Obesity Science & Practice · doi:10.1002/osp4.70006 · Cited by 10 · see citing works
Ryan, L., O’Donoghue, G., Crotty, M., Birney, S., Heary, C., Hanlon, M. L. D., Conlan, O., & Walsh, J. C. (2024) · Obesity Science & Practice · doi:10.1002/osp4.70012 · Cited by 10 · see citing works
Ryan, L., Coyne, R., Heary, C., Birney, S., Crotty, M., Dunne, R., Conlan, O., & Walsh, J. C. (2022) · International Journal of Qualitative Methods · doi:10.1177/16094069221102710 · Cited by 10 · see citing works
Discussion of Weight Loss Surgery in Instagram Posts: Successive Sampling Study
Meleo-Erwin, Z. C., Basch, C. H., Fera, J., & Smith, B. (2021) · JMIR Perioperative Medicine · doi:10.2196/29390 · Cited by 10 · see citing works
Weightism in Asia: A Narrative Review and Implications for Practice
Mathialagan, S., & Lau, P. L. (2024) · Journal of Obesity & Metabolic Syndrome · doi:10.7570/jomes24033 · Cited by 9 · see citing works
L’obésité chez l’adulte : ligne directrice de pratique clinique
Wharton, S., Lau, D. C. W., Vallis, M., Sharma, A. M., Biertho, L. D., Campbell-Scherer, D. L., Adamo, K. B., Alberga, A. S., Bell, R. C., Boulé, N. G., et al. (2020) · Canadian Medical Association Journal · doi:10.1503/cmaj.191707-f · Cited by 9 · see citing works
Self-citationPurcell, M., Reeves, R., & Mayfield, M. (2022) · PLoS ONE · doi:10.1371/journal.pone.0269745 · Cited by 9 · see citing works
Roberts, K. J., & Chaves, E. A. (2023) · Nutrients · doi:10.3390/nu15081861 · Cited by 9 · see citing works
Dagan, S. S., Ofri, L., Tayar, I., Keisar, I., Buch, A., Paska-Davis, N., Pinus, M., Tesler, R., Elran‐Barak, R., Boaz, M., et al. (2024) · Obesity Research & Clinical Practice · doi:10.1016/j.orcp.2023.12.002 · Cited by 8 · see citing works
Colangeli, L., Russo, B., Capristo, E., Mariani, S., Tuccinardi, D., Manco, M., Scipione, V., Parrotta, M. E., Capoccia, D., & Guglielmi, V. (2024) · Frontiers in Endocrinology · doi:10.3389/fendo.2024.1434360 · Cited by 8 · see citing works
Weight Bias in the Perinatal Period: An Integrative Review
Bradford, H. M., Puhl, R. M., Phillippi, J. C., Dietrich, M. S., & Neal, J. L. (2024) · Birth · doi:10.1111/birt.12870 · Cited by 8 · see citing works
Clinical observations of weight stigma among nursing students: A descriptive approach
Kerbyson, M., & Clark, K. D. (2024) · Obesity Science & Practice · doi:10.1002/osp4.70008 · Cited by 8 · see citing works
Clarke, C., Kirby, J. N., & Best, T. (2024) · Clinical Obesity · doi:10.1111/cob.12727 · Cited by 8 · see citing works
Rodríguez, Y. M. A., González, C. M. M., & Hernández, A. M. G. (2025) · Nursing Reports · doi:10.3390/nursrep15020066 · Cited by 8 · see citing works
- Authors
- Alberga, A. S., Edache, I. Y., Forhan, M., & Russell-Mayhew, S.
- Affiliations
- Concordia University (CA)
- University of Alberta (CA)
- Corresponding author
- Alberga, Angela S.
- Venue
- Primary Health Care Research & Development
- Publisher
- Cambridge University Press (CUP)
- Published
- 2019
- Volume
- 20
- Pages
- e116-e116
- ISSN
- 1463-4236 (ISSN-L)
- 1477-1128
- PMC
- PMC6650789
- OpenAlex
- W2963174560
- Semantic Scholar
- 3ddb8d0f8b7f175fcb188f006c0c9a9ec4f5faa3
- Cited by
- 348
- References
- 42
- Citations by year
- 2026: 37 · 2025: 71 · 2024: 110 · 2023: 50 · 2022: 38 · 2021: 28 · 2020: 12 · 2019: 1
- FWCI
- 3.80
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Primary Health Care Research & Development (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Libraries and Cultural Resources (University of Calgary) (publishedVersion, cc-by)
- Funders
- Concordia University
- Canadian Institutes of Health Research
- Topics
- Health Sciences › Health Professions › Pharmacy › Obesity and Health Practices
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- weight bias, obesity, health care utilization, primary care, patient engagement, doctor shopping, patient trust, clinician attitudes, barriers to care, weight stigma
- MeSH terms
- Weight Prejudice, Adult, Aged, Aged, 80 and over, Body Weight, Female, Humans, Male, Middle Aged, Obesity, Patient Acceptance of Health Care, Primary Health Care, Body Mass Index, Qualitative Research
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