Weight stigma and diabetes stigma in U.S. adults with type 2 diabetes: Associations with diabetes self-care behaviors and perceptions of health care

Puhl, Rebecca M.; Himmelstein, Mary S.; Hateley-Browne, Jessica L.; Speight, Jane

doi:10.1016/j.diabres.2020.108387

Cited by 49 publications

(55 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Together, these findings parallel emerging US studies implicating both experienced weight stigma [22,23,25,28] and WBI [22,28] as factors associated with poorer patient-provider relationships and reduced quality of care, both in community samples [23,28] and among samples of people with medical diagnoses like type 2 diabetes [22] and hypothyroidism [25]. Given limited research attention to these relationships in treatment-seeking and general population samples, our findings underscore the need for increased research studies to assess the effects of WBI on healthcare utilization, quality, and patient outcomes, which have not yet been adequately examined in the literature.…”

Section: Discussionsupporting

confidence: 81%

“…Additionally, weight stigma has concerning implications for patient-provider interactions and patients' healthcare utilization, as evidenced in US studies [10,15,21]. People who feel judged about their weight from a doctor report lower quality interactions with healthcare providers [22], less frequent clinician-patient interactions [22], lower trust in their primary care provider [23], and are more likely to switch doctors because of perceived differential treatment because of their weight [24]. Furthermore, perceived weight stigma during medical visits is associated with worsened provider-patient relationships and adherence [25], lower perceived physician empathy [26], and intentions to avoid future medical appointments [27].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The roles of experienced and internalized weight stigma in healthcare experiences: Perspectives of adults engaged in weight management across six countries

et al. 2021

Self Cite

View full text Add to dashboard Cite

Background/Objectives Considerable evidence from U.S. studies suggests that weight stigma is consequential for patient-provider interactions and healthcare for people with high body weight. Despite international calls for efforts to reduce weight stigma in the medical community, cross-country research is lacking in this field. This study provides the first multinational investigation of associations between weight stigma and healthcare experiences across six Western countries. Methods Participants were 13,996 adults residing in Australia, Canada, France, Germany, the UK, and the US who were actively enrolled in an internationally available behavioral weight management program. Participants completed identical online surveys in the dominant language for their country that assessed experienced weight stigma, internalized weight bias, and healthcare behaviors and experiences including perceived quality of care, avoidance or delay of seeking care, experiences with providers, and perceived weight stigma from doctors. Results Among participants who reported a history of weight stigma (56–61%), two-thirds of participants in each country reported experiencing weight stigma from doctors. Across all six countries, after accounting for demographics, BMI, and experienced stigma, participants with higher internalized weight bias reported greater healthcare avoidance, increased perceived judgment from doctors due to body weight, lower frequency of obtaining routine checkups, less frequent listening and respect from providers, and lower quality of healthcare. Additionally, experienced weight stigma (from any source) was indirectly associated with poorer healthcare experiences through weight bias internalization, consistently across the six countries. Conclusions Weight stigma in healthcare is prevalent among adults actively engaged in weight management across different Western countries, and internalized weight bias has negative implications for healthcare even after controlling for BMI. The similar findings across all six countries underscore the negative consequences of weight stigma on healthcare behaviors and experiences, and emphasize the need for collective international efforts to address this problem.

show abstract

Section: Discussionsupporting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

The roles of experienced and internalized weight stigma in healthcare experiences: Perspectives of adults engaged in weight management across six countries

et al. 2021

Self Cite

View full text Add to dashboard Cite

show abstract

“…The stigma surrounding diabetes has important negative effects on both the metabolic compensation and quality of life of people with the disease [ 18 , 19 , 20 , 21 ]. However, the mechanisms involved in this relationship still require investigation.…”

Section: Introductionmentioning

confidence: 99%

“…However, the mechanisms involved in this relationship still require investigation. Evidence in this area has shown that stigma can negatively affect psychosocial and behavioral aspects that are key to achieving good disease management [ 19 , 20 , 22 , 23 , 24 ].…”

Section: Introductionmentioning

confidence: 99%

“…Additionally, relationships with health care providers can be affected by perceived stigma, which may lead patients to avoid medical consultations [ 20 , 27 ]. Diabetes stigma has also been linked to less engagement in diabetes self-management behaviors (e.g., adherence to pharmacological treatments and lifestyle changes) [ 19 , 23 , 26 , 28 ].Some psychosocial variables, such as those mentioned above, may have a mediation role in the relationship between stigma and self-management behaviors [ 12 , 20 , 23 , 26 , 29 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A Cross-Sectional Analysis of the Stigma Surrounding Type 2 Diabetes in Colombia

Pedrero

Manzi

Alonso

2021

IJERPH

View full text Add to dashboard Cite

Type 2 diabetes is a global epidemic, and many people feel stigmatized for having this disease. The stigma is a relevant barrier to diabetes management. However, evidence in this regard is scarce in Latin America. This study aimed to analyze the level of stigma surrounding type 2 diabetes in the Colombian population and its relationships with sociodemographic, clinical, psychosocial variables and behaviors related to management of the disease (self-management behaviors). This cross-sectional study included 501 Colombian adults with type 2 diabetes. We estimated the relation between stigma and selected variables through linear regression models. Additionally, we analyzed the mediator role of psychosocial variables in the relationship between stigma and self-management behaviors through structural equation models. A total of 16.4% of patients showed concerning levels of stigma. The time elapsed since diagnosis (β = −0.23) and socioeconomic status (β = −0.13) were significant predictors of the level of stigma. Stigma was negatively correlated with self-efficacy (β = −0.36), self-esteem (β = −0.37), and relationship with health care provider (β = −0.46), and positively correlated with stress (β = 0.23). Self-efficacy, self-esteem, and the relationships with health care providers had a mediation role in the relationship between stigma and self-management behaviors. These variables would be part of the mechanisms through which the perception of stigma harms self-management behaviors. The stigma of type 2 diabetes is frequent in the Colombian population and negatively associated with important aspects of disease management.

show abstract

Bariatric surgery in adults with obesity and diabetes mellitus: a network meta-analysis

Kiesswetter,

Stadelmaier,

Schwarzer

et al. 2024

Cochrane Database of Systematic Reviews

View full text Add to dashboard Cite

Weight stigma and diabetes stigma in U.S. adults with type 2 diabetes: Associations with diabetes self-care behaviors and perceptions of health care

Cited by 49 publications

References 35 publications

The roles of experienced and internalized weight stigma in healthcare experiences: Perspectives of adults engaged in weight management across six countries

The roles of experienced and internalized weight stigma in healthcare experiences: Perspectives of adults engaged in weight management across six countries

A Cross-Sectional Analysis of the Stigma Surrounding Type 2 Diabetes in Colombia

Bariatric surgery in adults with obesity and diabetes mellitus: a network meta-analysis

Contact Info

Product

Resources

About