Stigma of health care professionals toward people with obesity: systematic review
DOI:
https://doi.org/10.29105/respyn25.1-928Keywords:
stigma, obesity, health professionalsAbstract
Introduction: Obesity is a chronic disease that, beyond its physical implications, carries a strong social stigma, even within healthcare settings. Objective: This study aims to analyze scientific evidence available between 2015-2025 on stigma of health care professionals and students toward people with obesity. Method: A systematic review was conducted following the guidelines of the PRISMA statement. The search was carried out on PubMed, EBSCO and ScienceDirect, identifying 267 articles. After the screening and eligibility evaluation process, 8 studies were included. Results: Stigma toward individuals with obesity is expressed through negative attitudes and individualistic attributions, in clinical and educational contexts. Differences were observed by discipline, country, educational level, and personal characteristics of professionals; however, a limitation of this review was the restriction to articles available in full text. Conclusion: Weight stigma and weight bias are prevalent among healthcare professionals and students. Strengthening empathetic communication, adopting wellness-centered care models, and promoting curricular changes that integrate a multifactorial view of obesity and eliminate discriminatory practices are essential.
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Alberga, A. S., Nutter, S., MacInnis, C., Ellard, J. H., & Russell-Mayhew, S. (2019). Examining weight bias among practicing Canadian family physicians. Obesity facts, 12(6), 632–638.
https://doi.org/10.1159/000503751 DOI: https://doi.org/10.1159/000503751
Allport, G. W., & Malfé, R. E. (1971). La naturaleza del prejuicio (4ª ed.). Eudeba.
André, W. dos S. S., Resende, T. R. O., & De Carvalho, P. H. B. (2024). Weight Stigma among Undergraduate Healthcare Students: A Vignette Study. Obesities, 4(3), 329–340.
https://doi.org/10.3390/obesities4030026 DOI: https://doi.org/10.3390/obesities4030026
Annunziata, G., Zonzini, G. B., Frias-Toral, E., Zambrano-Villacres, R., Bertuccioli, A., Sisti, D., Verde, L., Di Pauli, D., Colao, A., Muscogiuri, G., Simancas-Racines, D., Gennaro, A., & Barrea, L. (2025). Beyond dietary therapy: Addressing weight stigma awareness in medical students. Journal of Translational Medicine, 23(1), 951. https://doi.org/10.1186/s12967-025-06981-7 DOI: https://doi.org/10.1186/s12967-025-06981-7
Ansari, S., Haboubi, H. & Haboubi, N. (2020). Adult obesity complications: Challenges and clinical impact. Therapeutic Advances in Endocrinology and Metabolism, 11, 1-4.
https://doi.org/10.1177/2042018820934955 DOI: https://doi.org/10.1177/2042018820934955
Apovian, C. (2016). Obesity: Definition, comorbidities, causes, and burden. The American Journal of Managed Care, 22, S176-S185.
Bahamdan, A. S., Shafey, M. M., Alabdulkader, A. M., Aldhawyan, A. F., Alharkan, K. S., Almohaimeed, O. K., & Holdar, M. J. (2024). Obesity Stigma Among Healthcare Workers in a Teaching Hospital in Saudi Arabia. Journal of Primary Care & Community Health, 15, 21501319241303326.
https://doi.org/10.1177/21501319241303326 DOI: https://doi.org/10.1177/21501319241303326
Bannuru, R. R. (2025). Weight stigma and bias: Standards of care in overweight and obesity—2025. BMJ open diabetes research & care, 13(Suppl 1). DOI: https://doi.org/10.1136/bmjdrc-2025-004962
Baska, A., Świder, K., Zgliczyński, W. S., Kłoda, K., Mastalerz-Migas, A., & Babicki, M. (2024). Is obesity a cause for shame? Weight bias and stigma among physicians, dietitians, and other healthcare professionals in Poland—A cross-sectional study. Nutrients, 16(7), 999.
https://doi.org/10.3390/nu16070999 DOI: https://doi.org/10.3390/nu16070999
Bastias-González, F., Jorquera, C., Matamala, C., Aguirre, P., Escandon-Nagel, N., Marileo, L., & Viscardi, S. (2022). El estigma de peso de los estudiantes de nutrición y dietética hacia las personas con obesidad. Revista chilena de nutrición, 49(3), 378–383. https://doi.org/10.4067/s0717-75182022000300378 DOI: https://doi.org/10.4067/s0717-75182022000300378
Bellikci-Koyu, E., Karaagac, Y., & Demirci, Ş. (2025). Assessing weight bias among Turkish dietitians: Determinants and impact on professional practice. BMC Medical Education, 25(1), 307.
https://doi.org/10.1186/s12909-025-06883-8 DOI: https://doi.org/10.1186/s12909-025-06883-8
Capoccia, D., Milani, I., Colangeli, L., Parrotta, M. E., Leonetti, F., & Guglielmi, V. (2025). Social, cultural and ethnic determinants of obesity: From pathogenesis to treatment. Nutrition, Metabolism and Cardiovascular Diseases, 35(6), 103901.
https://doi.org/10.1016/j.numecd.2025.103901 DOI: https://doi.org/10.1016/j.numecd.2025.103901
Cassiano, G. S., Carvalho-Ferreira, J. P., Buckland, N. J., & da Cunha, D. T. (2021). Do registered dietitians, nutrition students, and laypeople perceive individuals with obesity differently? International journal of environmental research and public health, 18(17), 8925. DOI: https://doi.org/10.3390/ijerph18178925
Elboim-Gabyzon, M., Attar, K., & Peleg, S. (2020). Weight stigmatization among physical therapy students and registered physical therapists. Obesity facts, 13(2), 104–116.
https://doi.org/10.1159/000504809 DOI: https://doi.org/10.1159/000504809
FitzGerald, C., & Hurst, S. (2017). Implicit bias in healthcare professionals: A systematic review. BMC medical ethics, 18(1), 19.
https://doi.org/10.1186/s12910-017-0179-8 DOI: https://doi.org/10.1186/s12910-017-0179-8
Harwood, A., Carter, D., & Eliott, J. (2022). A public health framework for reducing stigma: The example of weight stigma. Journal of bioethical inquiry, 19(3), 511–520. DOI: https://doi.org/10.1007/s11673-022-10199-3
Hauff, C., Fruh, S., Graves, R., Sims, B., Williams, S., Minchew, L., Hall, H., Platt, T. & Barclay, M. (2019). Nurse practitioner students’ awareness of obesity bias within clinical practice. The Nurse Practitioner, 44(6), 41–46. DOI: https://doi.org/10.1097/01.NPR.0000558157.76596.c7
Klobodu, S. S., Mensah, P. A., Willis, M., & Bailey, D. (2022). Weight bias among nutrition and dietetics students in a Ghanaian Public University. Journal of nutrition education and behavior, 54(5), 406–411. https://doi.org/10.1016/j.jneb.2022.01.007 DOI: https://doi.org/10.1016/j.jneb.2022.01.007
Lawrence, B. J., Kerr, D., Pollard, C. M., Theophilus, M., Alexander, E., Haywood, D., & O’Connor, M. (2021). Weight bias among health care professionals: A systematic review and meta‐analysis. Obesity, 29(11), 1802–1812. https://doi.org/10.1002/oby.23266 DOI: https://doi.org/10.1002/oby.23266
Obara, A., & Alvarenga, M. (2018). Adaptação transcultural da escala de atitudes antiobesidade para o português do Brasil. Ciência & Saúde Coletiva, 23, 1507–1520.
https://doi.org/10.1590/1413-81232018235.17252016 DOI: https://doi.org/10.1590/1413-81232018235.17252016
Obara, A., Vivolo, S., & Alvarenga, M. (2018). Weight bias in nutritional practice: A study with nutrition students. Cadernos de Saúde Pública, 34(8), e00088017.
https://doi.org/10.1590/0102-311X00088017 DOI: https://doi.org/10.1590/0102-311x00088017
Ocampo Zarate, H. N. (2023). Atribuciones causales de los éxitos y fracasos escolares en Educación Infantil. [Tesis de grado, Universidad de Valladolid]. https://uvadoc.uva.es/handle/10324/61999
O’Donoghue, G., Cunningham, C., King, M., O’Keefe, C., Rofaeil, A., & McMahon, S. (2021). A qualitative exploration of obesity bias and stigma in Irish healthcare: The patients’ voice. PLoS ONE, 16(11), e0260075. https://doi.org/10.1371/journal.pone.0260075 DOI: https://doi.org/10.1371/journal.pone.0260075
Organización Mundial de la Salud. (2025, 7 de mayo). Obesidad y sobrepeso. https://www.who.int/es/news-room/fact-sheets/detail/obesity-and-overweight
Pearl, R. L. (2018). Weight bias and stigma: Public health implications and structural solutions. Social Issues and Policy Review, 12(1), 146–182.
https://doi.org/10.1111/sipr.12043 DOI: https://doi.org/10.1111/sipr.12043
Phelan, S. M., Burgess, D. J., Yeazel, M. W., Hellerstedt, W. L., Griffin, J. M., & van Ryn, M. (2015). Impact of weight bias and stigma on quality of care and outcomes for patients with obesity. Obesity reviews, 16(4), 319–326. https://doi.org/10.1111/obr.12266 DOI: https://doi.org/10.1111/obr.12266
Puhl, R. M. (2023). Weight Stigma and Barriers to Effective Obesity Care. Gastroenterology Clinics of North America, Management of Obesity, Part I: Overview and Basic Mechanisms, 52(2), 417–428. https://doi.org/10.1016/j.gtc.2023.02.002 DOI: https://doi.org/10.1016/j.gtc.2023.02.002
Puhl, R. M., & Heuer, C. A. (2009). The Stigma of Obesity: A Review and Update. Obesity, 17(5), 941–964. https://doi.org/10.1038/oby.2008.636 DOI: https://doi.org/10.1038/oby.2008.636
Rubino, F., Puhl, R. M., Cummings, D. E., Eckel, R. H., Ryan, D. H., Mechanick, J. I., Nadglowski, J., Ramos Salas, X., Schauer, P. R., & Twenefour, D. (2020). Joint international consensus statement for ending stigma of obesity. Nature medicine, 26(4), 485–497. https://doi.org/10.1038/s41591-020-0803 DOI: https://doi.org/10.1038/s41591-020-0803-x
Salle, L., Foulatier, O., Coupaye, M., Frering, V., Constantin, A., Joly, A.-S., Braithwaite, B., Gharbi, F., & Jubin, L. (2024). ACTION-FRANCE: Insights into Perceptions, Attitudes, and Barriers to Obesity Management in France. Journal of Clinical Medicine, 13(12). https://doi.org/10.3390/jcm13123519 DOI: https://doi.org/10.3390/jcm13123519
Sánchez-Carracedo, D. (2022). El estigma de la obesidad y su impacto en la salud: Una revisión narrativa. Endocrinología, diabetes y nutrición, 69(10), 868–877. DOI: https://doi.org/10.1016/j.endinu.2021.12.002
Schwartz, M. B., Chambliss, H. O., Brownell, K. D., Blair, S. N., & Billington, C. (2003). Weight Bias among Health Professionals Specializing in Obesity. Obesity Research, 11(9), 1033–1039.
https://doi.org/10.1038/oby.2003.142 DOI: https://doi.org/10.1038/oby.2003.142
Shamah-Levy, T., Lazcano-Ponce, E., Cuevas-Nasu, L., Romero-Martínez, M., Gaona-Pineda, E., Gómez-Acosta, L., Mendoza-Alvarado, L., & Méndez-Gómez-Humarán, I. (2024). Encuesta Nacional de Salud y Nutrición Continua 2023: Resultados Nacionales. [Informe de resultados]. Instituto Nacional de Salud Pública. DOI: https://doi.org/10.21149/15168
https://insp.mx/resources/images/stories/2025/docs/250108_Ensanut_23.pdf
Sohier, L., Ravet, M.-S., Berger-Vergiat, A., & Iceta, S. (2025). Bias related to overweight and obesity among French psychiatrists: Results of a national survey. L’Encéphale, 51(4), 355–360.
https://doi.org/10.1016/j.encep.2024.06.003 DOI: https://doi.org/10.1016/j.encep.2024.06.003
Stewart, S.-J. F., & Ogden, J. (2021). The role of social exposure in predicting weight bias and weight bias internalisation: An international study. International Journal of Obesity, 45(6), 1259–1270.
https://doi.org/10.1038/s41366-021-00791-9 DOI: https://doi.org/10.1038/s41366-021-00791-9
Talumaa, B., Brown, A., Batterham, R. L., & Kalea, A. Z. (2022). Effective strategies in ending weight stigma in healthcare. Obesity Reviews, 23(10), e13494. https://doi.org/10.1111/obr.13494 DOI: https://doi.org/10.1111/obr.13494
Westbury, S., Oyebode, O., van Rens, T., & Barber, T. M. (2023). Obesity Stigma: Causes, Consequences, and Potential Solutions. Current Obesity Reports, 12(1), 10–23. https://doi.org/10.1007/s13679-023-00495-3 DOI: https://doi.org/10.1007/s13679-023-00495-3
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