The objective of this study was to critically review the empirical evidence from all relevant disciplines regarding obesity stigma in order to (i) determine the implications of obesity stigma for healthcare providers and their patients with obesity and (ii) identify strategies to improve care for patients with obesity. We conducted a search of Medline and PsychInfo for all peer-reviewed papers presenting original empirical data relevant to stigma, bias, discrimination, prejudice and medical care. We then performed a narrative review of the existing empirical evidence regarding the impact of obesity stigma and weight bias for healthcare quality and outcomes. Many healthcare providers hold strong negative attitudes and stereotypes about people with obesity. There is considerable evidence that such attitudes influence person-perceptions, judgment, interpersonal behaviour and decision-making. These attitudes may impact the care they provide. Experiences of or expectations for poor treatment may cause stress and avoidance of care, mistrust of doctors and poor adherence among patients with obesity. Stigma can reduce the quality of care for patients with obesity despite the best intentions of healthcare providers to provide high-quality care. There are several potential intervention strategies that may reduce the impact of obesity stigma on quality of care.

<h4>Objective</h4>To investigate whether negative implicit attitudes and beliefs toward overweight persons exist among health professionals who specialize in obesity treatment, and to compare these findings to the implicit anti-fat bias evident in the general population.<h4>Design</h4>Health care professionals completed a series of implicit and explicit attitude and belief measures. Results were compared to measures obtained from a general population sample.<h4>Subjects</h4>A total of 84 health professionals who treat obesity (71% male, mean age 48 y, mean body mass index (BMI) 25.39).<h4>Measurements</h4>Participants completed an attitude- and a belief-based lmplicit Association Test. This reaction time measure of automatic memory-based associations asked participants to classify words into the following target category pair. 'fat people' vs 'thin people'. Simultaneously, the tasks required categorization of words into one of the following descriptor category pairs: good vs bad (attitude measure) or motivated vs lazy (stereotype measure). Participants also reported explicit attitudes and beliefs about fat and thin persons.<h4>Results</h4>Clear evidence for implicit anti-fat bias was found for both the attitude and stereotype measures. As expected, this bias was strong but was lower than bias in the general population. Also as predicted, only minimal evidence for an explicit anti-fat bias was found. Implicit and explicit measures of the lazy stereotype were positively related although the attitude measures were not.<h4>Conclusion</h4>Even health care specialists have strong negative associations toward obese persons, indicating the pervasiveness of the stigma toward obesity. Notwithstanding, there appears to be a buffering factor, perhaps related to their experience in caring for obese patients, which reduces the bias.

<h4>Objective</h4>To investigate the implicit and explicit prejudice of physical education (PE) students before, and following extensive professional training, and to examine the relationship of anti-fat prejudice to relevant psychosocial predictors.<h4>Design</h4>Implicit and explicit anti-fat prejudice of year one and three PE students (cross-sectional sample) were assessed and compared to a similarly matched (age, body mass index (BMI), education) sample of psychology students.<h4>Subjects</h4>Three hundred and forty-four university students, 180 PE students, 164 psychology students (67% female, mean age 20 years, BMI: mean 23.18 kg/m(2)).<h4>Measurements</h4>Measures of implicit and explicit anti-fat prejudice were administered to PE and psychology students in either their second week, or near completion of their third year, of university study. Physical identity, body esteem and social dominance orientation (SDO) were assessed in order to establish their relationship with anti-fat bias.<h4>Results</h4>PE students displayed higher levels of implicit anti-fat bias than psychology students, and other health professionals. Additionally, year three PE students displayed higher levels of implicit anti-fat attitudes than year one PE students. The higher implicit anti-fat biases exhibited by year three PE students were associated with SDO, and lower body esteem.<h4>Conclusion</h4>Physical educators, and particularly those more socialized in the PE environment, display strong negative prejudice toward obese individuals that is greater than that displayed by other groups. These prejudices appear to be supported by an over-investment in physical attributes, and ideological beliefs.

This paper is the first to apply the contact hypothesis, a social psychological theory of prejudice reduction, to the field of weight bias. It aims to investigate whether contact with overweight people is associated with the extent to which people report weight bias, as well as vigilance around their own bodies. In 2013 we recruited 1176 American participants to complete surveys regarding prejudice toward overweight people, as well as a suite of measures capturing people's relationships with their own weight (fat talk, drive for thinness, and body-checking behavior). Positive contact with overweight people predicted decreased prejudice, regardless of whether participants were overweight (p < .001) or not (p = .003). However, negative contact was a stronger predictor of increased prejudice (p < .001 for both samples). For non-overweight participants, any contact with overweight people (whether positive or negative) predicted increased body-checking behaviors (positive-p = .002, negative-p < .001) and fat talk (positive-p = .047, negative-p < .001), and negative contact predicted increased drive for thinness (p < .001). However, for those who were overweight a different picture emerged. While negative contact predicted increased body-checking behaviors (p < .001) and fat talk (p < .001), positive contact was protective, predicting decreased drive for thinness (p = .001) and body-checking behaviors (p < .001). This paper demonstrates that the interactions we have with overweight people are inherently tied to both our attitudes towards them and our relationship with our own bodies.

Aim and objectives.  To determine the implicit or unconscious attitudes of Nursing and Psychology majors towards overweight individuals in medical and non‐medical contexts.Background.  Obesity is a leading health concern today, which impacts both physical and psychological health. Overweight individuals confront social biases in many aspects of their lives including health care. Examining the views of Nursing and Psychology students may reveal implicit attitudes towards overweight individuals that may lead to prejudiced behaviours.Design.  A mixed design experiment with one between‐subjects variable (student major: Nursing or Psychology) and one within‐subjects variable (condition: congruent or incongruent) was used to assess implicit attitudes in two convenience samples of Nursing and Psychology students.Methods.  A computerised implicit association test was used to determine implicit attitudes towards overweight individuals in medical and non‐medical contexts. A total of 90 students from Nursing (n = 45) and Psychology (n = 45) were recruited to complete an implicit association test. Reaction times in milliseconds between the congruent trials (stereotype consistent) and incongruent trials (stereotype inconsistent) were compared with determine adherence to social stereotypes or weight bias.Results.  A statistically significant implicit bias towards overweight individuals was detected in both subject groups and in both target settings (medical vs. non‐medical). Stronger weight bias was found when the stimulus targets were female than male.Conclusions.  Findings from this study expand understanding of the implicit attitudes and social biases of Nursing and Psychology students. The views held by these future healthcare professionals may negatively impact patient care.Relevance to clinical practice.  Providing education and support to overweight individuals is central to Nursing practice in a society struggling to manage obesity. Negative stereotypes or beliefs about these individuals may result in poor patient care. Therefore, nurses and other healthcare professionals must be aware of personal biases and work to develop methods to address weight‐related issues in a therapeutic manner.

Social stigma of obesity is bias or discriminatory behaviors targeted at overweight and obese individuals because of their weight and high body fat percentage Social stigma of obesity is bias or discriminatory behaviors targeted at overweight and obese individuals because of their weight and high body fat percentage. Such social stigmas can span one's entire life as long as excess weight is present, starting from a young age and lasting into adulthood. Stigmatization of obesity is usually associated with increased health risks (morbidity) of being overw Social…