Weight stigma in health care
Weight stigma is experienced by people with obesity in healthcare settings. This page outlines the impact of weight stigma in healthcare settings. It provides advice and resources for health professionals to reduce weight stigma in their practice and better support their patients’ health, regardless of their patients’ weight.
Key Evidence
Weight stigma and bias refers to negative attitudes toward and beliefs about others because of their weight, and is experienced in a range of settings including healthcare
Weight stigma contributes to the avoidance of, or delays in receiving appropriate healthcare
Widespread changes are needed to reduce weight stigma in the community and healthcare settings. Training and professional development opportunities for healthcare professionals are recommended along with clear practical guidelines on non-stigmatising provision of healthcare, including size-inclusive spaces and equipment
This page is specific to weight stigma in healthcare. For evidence on the general prevalence and impact of weight stigma, please see the Obesity Evidence Hub page Weight stigma, bias and discrimination.
Prevalence of weight stigma in healthcare settings
Many people with obesity experience weight stigma and harm in healthcare settings.1234 Similar to the general public, some healthcare professionals believe that patients with obesity are entirely responsible for their own weight and may also internalise social stereotypes about obesity and regard patients with obesity as lazy, non-compliant and lacking motivation.5 This has implications for the therapeutic relationship between healthcare professionals and patients across the healthcare continuum. A systematic review and meta-analysis found explicit and implicit weight bias from a range of healthcare professionals toward people living with obesity.4 More than half of all health professionals exhibit some form of weight bias towards people with obesity.6 Patients with obesity have described negative treatment by healthcare providers, including lack of respect and compassion, lower levels of emotional rapport, examples of verbal insults, inappropriate humour, unsolicited lecturing about weight loss, unmet healthcare needs, and breaches of dignity.789
Consequences of weight stigma in healthcare settings
The experience of weight stigma in healthcare can reduce the standard of care received by people with obesity, as well as diminishing trust in healthcare professionals and avoiding seeking healthcare.101112
Healthcare professionals can use hurtful, stigmatising language and display negative attitudes and behaviours.1011 They may also give simplistic advice (eat less, move more) and overlook other causes of ill health by wrongly attributing symptoms to obesity, which can have serious consequences for individuals’ health and wellbeing.1011 In addition, the physical or structural environment of healthcare settings may itself contribute to stigma.511 Providing inappropriate equipment, such as seats, beds or toilets that are not wide or sturdy enough for people with obesity to comfortably use; providing gowns or blood pressure cuffs that do not accommodate larger bodies; and insensitive signage to clinics, all produce or contribute to stigma.511
Figure 1: Impact of weight bias and stigma on quality of care and outcomes for patients with obesity
A conceptual model of hypothesised pathways whereby the associations between obesity and health outcomes are partially mediated by healthcare providers' attitudes and behaviours about obese patients, and patients' response to feeling stigmatised.
Phelan SM, Burgess D, Yeazel M, Hellerstedt W, Griffin J, Ryn M: Impact of weight bias and stigma on quality of care and outcomes for patients with obesity. Obes Rev 2015;16:319–26.
Reducing weight bias and stigma in healthcare
Significant change is required to reduce the prevalence and harms of weight stigma.123101314 Healthcare is a key setting to address weight stigma and improve the medical treatment provided to people with obesity.115 There is limited evidence on effective approaches to reduce weight stigma in healthcare.3 Recommendations from multiple sources highlight the need for education and training to improve health professionals understanding of the complex causes of obesity and the harms of weight stigma to move away from the ‘personal responsibility’ narrative.11315 Professional bodies such as the Royal Australian College of General Practitioners (RACGP) recognise the harms of weight stigma and also call for increased education and training of their members.16 The RACGP commit to reducing stigma by using person-first language, not using stigmatising images or messages and encourage general practitioners (GPs) to centre obesity management on improving health, wellbeing and quality of life.17 Weight stigma was also included in the draft Clinical Practice Guidelines for the Management of Overweight and Obesity for Adults, Adolescents and Children in Australia, with the draft consulted on in November 2024 encouraging healthcare professionals to consider weight stigma in their practice, complete relevant professional development and take action to reduce weight stigma in their consultations and physical clinic setup.17 Final guidelines had not been released as at June 2025.
It is important to engage people with obesity and include their perspectives in strategies to address weight stigma. The Weight Issues Network (WIN) is a national organisation established in 2019 to provide a voice and support for people living with and affected by overweight or obesity. WIN has produced the advocacy report ‘The Personal Costs of Weight Issues in Australia’, which shares the lived experiences of people with obesity.14 The report includes recommendations for medical and health professionals to better support people with obesity, see Table 1.
Table 1: WIN recommendations for healthcare professionals
Weight Issues Network. The personal costs of weight issues in Australia. Australia; WIN: 2020.
https://weightissuesnetwork.org/advocacy-report/
| Please Do | Please Do Not |
|---|---|
| Focus on health and wellbeing. | Make assumptions about our knowledge or efforts. For example, just because a patient has obesity it does not mean that we know nothing about healthy eating or exercise. |
| Treat everyone with respect and dignity. | Assume that everyone wants to or is in a good position to lose weight. This can change with life circumstances. |
| Understand that for some of us, this is a difficult topic. | Think that there is one solution for everyone. |
| Be open. Someone may or may not want to talk about obesity. Ask people what they are comfortable and OK with. | Let the patient walk out of your office thinking they are alone. |
| Help us understand options to improve our health in an open, honest and nonjudgmental way. Explore different options and take time to tell us about the evidence around obesity and weight loss approaches. | Make patients wait too long between appointments. |
| Listen to people’s story to better understand what is happening. | Decide that care for people with obesity is a lower priority than other health services/people. |
| Practice person centred care and consider what is feasible/possible for an individual based on their situation and needs. | |
| Be honest about the challenges of weight regain. | |
| Offer well rounded, evidence-based support/program options. | |
A group of Australian researchers, community members with lived experience, healthcare professionals and health policy professionals participated in a workshop to develop recommendations for reducing weight stigma in healthcare.3 The recommendations were published in 2024 and focus on four themes: support, not blame; acknowledge personal biases; address structural drivers of weight stigma; and transdisciplinary action. In addition to the recommendations below, they also highlighted the need for policy changes that improve social, physical and fiscal environments.3 Specifically, their recommendations to address weight stigma in clinical practice are as follows:3
- Frame weight stigma reduction initiatives to appeal to healthcare professionals’ morals
- Increase professional training opportunities to recognise and address weight stigma
- Implement clear practical guidelines on non-stigmatising care provision
- Implement physical environment checklists to address structural drivers of weight stigma
- Develop formal pathways and strategies to optimise transdisciplinary collaboration and patient care
Organisations reducing weight stigma, providing weight inclusive resources for individuals and clinicians
The Obesity Collective is Australia’s peak body for obesity, with a vision to reduce the health and wellbeing impacts of obesity. One of its core principles is to fight weight stigma and their website includes a range of resources to support this, such as the e-learning module Understanding the Science and Reality of Obesity for Better Patient Care.
The Weight Issues Network (WIN) is a national organisation established in 2019 to provide a voice and support for people living with and affected by overweight or obesity. The network includes those with lived experience, along with parents, carers, family members, friends and clinicians. WIN is active in promoting improved health care policies for obesity, and fighting weight stigma, bias and discrimination.
Size Inclusive Health Australia is a non-profit, member-based association that brings together health care professionals, training and the highest quality information for size inclusive care, including the Health at Every Size® (HAES®) approach. Their website includes a list of Size Inclusive Healthcare Providers across Australia that take a weight-neutral approach.
Eating disorder organisations also offer relevant resources and support weight stigma. The National Eating Disorders Collaboration (NEDC) works to improve the understanding, prevention and treatment of eating disorders in Australia. NEDC has developed clinical practice guidelines for the management of eating disorders for people with higher weight. The Butterfly Foundation is dedicated to supporting people affected by eating disorders and body dissatisfaction. Both organisations work to reduce weight stigma, elevate lived experienced perspectives and support weight-inclusive healthcare.
Content for this page was reviewed and updated by Josephine Marshall at Deakin University, and reviewed by Helen Dixon at the Centre for Behavioural Research in Cancer at Cancer Council Victoria. For more information about the approach to content on the site please see About | Obesity Evidence Hub.