Cited by 348Obesity and Health PracticesPatient-Provider Communication in HealthcareMental Health Treatment and Access

The DOI matches its Crossref record; 43 of the 43 references it cites were found in a registry or an index; none of the 93 sources its claims cite is checked for support yet.

Weight bias and health care utilization: a scoping review

Open access
Alberga, Angela S., Edache, Iyoma Y., Forhan, Mary, Russell-Mayhew, Shelly·2019·Primary Health Care Research & Development

Abstract

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.

Overview

AI snapshot

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.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1017/s1463423619000227

Cites

43 of 43 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Figures

Figure 1. PRISMA-ScR flowchart illustrating the process of article selection.
Figure 1. PRISMA-ScR flowchart illustrating the process of article selection.CC BY · PubMed Central

Verification

Claims the paper makes

55 Not checked yet · 15 Own result · 5 Own interpretation · 3 Own method · 2 No basis given

Verify all 93 references — free account

Show all 52 claims

  • Probably not a substantial claim. 18
  • It may state two separate claims as one. 13
28 of 28
  • 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.”
3 of 3

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?

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.

4 of 4

Citations

Cites

Show all 42 references

Cited by

Sorted by citations

Items 201–300 of 348

Metadata

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
Published
2019
Volume
20
Pages
e116-e116
ISSN
  • 1463-4236 (ISSN-L)
  • 1477-1128
OpenAlex
W2963174560
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
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 › Medicine › Public Health, Environmental and Occupational Health › Obesity and Health Practices
  • Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
  • Health Sciences › Medicine › Psychiatry and Mental health › 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

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

A language model drew the claims from the paper on 2026-10-09, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).

A second model labelled each claim on 2026-10-09 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review