Impact of Perceived Weight Stigma among Underserved Women on Doctor-Patient Relationships

Abstract

Objective: To evaluate how perception of weight stigma among underserved women with obesity impacts doctor-patient relationships.

Methods: This study consisted of an interviewer-administered survey of 149 women with obesity (BMI ≥ 30 kg/m²) immediately after their physician visit at four Federally Qualified Health Centers. Perceptions of weight stigma and physician empathy were measured using the Stigma Situations in Health Care instrument and Consultation and Relational Empathy (CARE) measure, respectively. Associations of CARE and Stigma scores with BMI and patient characteristics were analyzed using Mantel-Haenszel chi-square test and ordinal logistic regression.

Results: The mean CARE score was 42.1 (sd 8.4; range 11.0-50.0) and mean Stigma score was 4.6 (sd 7.6; range 0-43.0). Each increase in BMI category was associated with almost 2-fold increased odds of higher perception of Stigma (OR, 1.90, 95% CI 1.30-2.78, p=0.001). BMI was not associated with CARE. However, for each increase in stigma category, the odds of lower CARE score doubled (OR, 0.52, 95% CI 0.36-0.75, p=0.0005).

Conclusion: While BMI was not associated with perception of physician empathy, higher frequency of weight stigmatizing situations was negatively associated with perception of physician empathy. Reducing weight stigma in primary care could improve doctor-patient relationships and quality of care in patients with obesity.

Keywords: minorities; obesity; patient-provider communication; primary care; weight stigma.