Women’s Relationships With Healthcare and Providers: The Role of Weight Stigma in Healthcare and Weight Bias Internalization

Abstract Background Weight stigma (devaluation due to body weight) in healthcare is common and influences one’s engagement in healthcare, health behaviors, and relationship with providers. Positive patient–provider relationships (PPR) are important for one’s healthcare engagement and long-term health. Purpose To date, no research has yet investigated whether weight bias internalization (self-stigma due to weight; WBI) moderates the effect of weight stigma on the PPR. We predict that weight stigma in healthcare is negatively associated with (i) trust in physicians, (ii) physician empathy, (iii) autonomy and competence when interacting with physicians, and (iv) perceived physician expertise. We also predict that those with high levels of WBI would have the strongest relationship between experiences of weight stigma and PPR outcomes. Methods We recruited women (N = 1,114) to complete a survey about weight stigma in healthcare, WBI and the previously cited PPR outcomes. Results Weight stigma in healthcare and WBI were associated with each of the PPR outcomes when controlling for age, BMI, education, income, race, and ethnicity. The only exception was that WBI was not associated with trust in physicians. The hypothesis that WBI would moderate the effect of weight stigma in healthcare on PPR outcomes was generally not supported. Conclusions Overall, this research highlights how weight stigma in healthcare as well as one’s own internalization negatively impact PPRs, especially how autonomous and competent one feels with their provider which are essential for one to take an active role in their health and healthcare.