Addressing weight stigma in clinical guidelines for obesity treatment: a systematic review

Objective This study aimed to evaluate how weight stigma is addressed in national and international clinical guidelines for the treatment of obesity. Methods A systematic review with qualitative synthesis was conducted, analyzing recommendations from clinical guidelines published between 2000 and 2022. Both national and international documents were included, with the goal of identifying the presence, emphasis, and treatment given to the topic of weight stigma. The search yielded 713 publications, of which only 26 met the inclusion criteria established for this study. Results The findings revealed that most of the analyzed guidelines do not meaningfully address weight stigma in their recommendations. Despite the importance of this issue for improving the quality of care for individuals with obesity, it remains underexplored, highlighting persistent gaps in the ethical and humanized approach to treatment. Conclusion The results underscore the urgent need to incorporate the discussion of weight stigma into clinical guidelines for obesity. Such incorporation is essential to foster an epistemological shift in how obesity is understood and managed in clinical contexts. This transformation requires coordinated efforts at multiple levels – individual, community, and systemic – and entails a reconfiguration of societal relations with fat bodies, as well as a redefinition of the very notion of healthcare.