Examining the impact of identity-safety cues on inclusion for adults with higher body weights in healthcare settings.
Veronica Derricks, Eva S Pietri, India R Johnson and 1 others
PMID 40097257WHAT IT FOUND
Adults with higher body weights felt safer and more trusting of a hypothetical physician who endorsed a weight-inclusive approach.
However, this benefit did not erase the harm of stigmatizing comments; when the physician attributed knee pain to weight, trust dropped sharply despite the inclusive cue.
Key findings
01Physicians who explicitly endorsed a weight-inclusive clinical approach (Health at Every Size) reduced patients' concerns about weight stigma and increased perceptions of allyship compared to a control message.
02Attributing a patient's knee pain to their body weight significantly lowered identity-safety and increased perceptions of the physician's dishonesty, even when the physician had previously displayed an inclusive cue.
03The inclusive cue did not fully protect against the negative impact of stigmatizing language; participants who saw both the cue and the stigmatizing diagnosis reported higher diversity dishonesty than those who saw only the stigmatizing diagnosis.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPsWhat it means for RNs
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What it does not show
The study used hypothetical vignettes and online participants, not actual clinical encounters, so real-world dynamics may differ. The sample was predominantly White (81.8%) and women (60%), limiting generalizability to other racial and gender groups. The stigmatizing condition involved a single statement; repeated or more nuanced stigmatizing behaviors might have different effects. The study did not measure actual health outcomes or care-seeking behaviors, only perceptions of safety and trust.
Declared interests
The authors declare no competing financial interests or personal relationships.
The easy way to misread this
Do not assume that displaying a weight-inclusive cue protects the patient relationship if you subsequently make weight-based attributions. The study found that this combination actually increased perceptions of dishonesty compared to making the stigmatizing attribution alone.