Weight stigma is pervasive in the US, with body size being pathologised and weight loss urged for those of higher weights. However, there is a growing movement for fat acceptance and body positivity. The present study explored perceptions and experiences of cultural body acceptance trends among Midwestern American women who are trying to, or have tried to, "accept" their bodies. Participants (n=18) are self-identified women who have ever been labelled 'obese' on the Body Mass Index and have ever tried to develop a more positive relationship with their bodies.Participants were interviewed three times over the course of approximately one year using a semi-structured interview guide that explored their perceptions of how society represented and treated those of a higher weight. Interviews were recorded and transcribed verbatim, and interviews and field-notes analysed thematically. Emergent themes included: greater (mixed) representation, lip service, and inclusive cultures. Ultimately, participants positioned shifting attitudes towards fat bodies within wider social trends toward greater inclusion and diversity in general, but remained frustrated by ceilings of acceptable size, disingenuous messaging, and cultural backsliding.

Weight stigma has become widespread within health care and disproportionately affects women, who are under greater appearance-based scrutiny than men. It is also well established that ruralbased individuals with low incomes suffer greater health disparities compared with urban, higher-income counterparts, yet studies examining recommendations for nonstigmatizing health care among higherweight women from low-income rural settings are lacking. This study examined the experiences and recommendations of higher-weight, low-income, rural women, with the aim of improving health care for similar populations. MethodsIn-depth, semi-structured interviews were conducted in a rural region of the Midwestern United States to explore participants' recommendations for redressing stigma within health care. All participants (n=25) self-identified as higher-weight, low-income, rural women. ResultsAll participants experienced or were aware of weight stigma within health care. Themes identified from responses were understanding patients and their situations, offering options and supplemental information, communicating effectively, taking time, and having a positive attitude. Patient recommendations focused on correcting physician biases, rapport-building, and providing holistic care. ConclusionsThe findings suggest that weight stigma is prevalent within health care provided to low-income women in rural U.S. Midwest and that there are specific communication and training approaches that may reduce the prevalence of weight stigma in health care.