Patient Educ Couns. 2025 May;134:108652. doi: 10.1016/j.pec.2025.108652. Epub 2025 Jan 12.
ABSTRACT
OBJECTIVES: Adults with higher body weights experience weight stigma in healthcare, which can heighten concerns about treatment in these settings. This study investigates whether a specific strategy-using an identity-safety cue, or a cue which signals that one’s social identity is valued-mitigates these concerns.
METHODS: 527 U.S. adults who self-identified as overweight were randomized to read about a hypothetical physician who endorsed a weight-inclusive clinical approach (identity-safety cue condition) or making health information accessible (control condition). Next, participants read a vignette where the physician attributed their persistent knee pain to their age (control diagnosis), lifestyle habits (ambiguous diagnosis), or body weight (stigmatizing diagnosis).
RESULTS: Exposure to the physician who employed the identity-safety (versus control) cue decreased weight stigma concerns, increased perceptions of physician allyship, and promoted identity-safety. While use of the identity-safety cue elicited benefits regardless of the physician’s clinical diagnosis, viewing the identity-safety cue alongside the stigmatizing diagnosis increased perceptions that the physician’s commitment to diversity was dishonest, which subsequently harmed feelings of safety.
CONCLUSIONS: Use of identity-safety cues in healthcare can effectively promote inclusion for adults with higher body weights. However, perceiving that the physician’s pro-diversity efforts are dishonest can undermine inclusion.
PRACTICE IMPLICATIONS: To effectively promote inclusion for adults with higher body weights, physicians should employ cues which explicitly signal that their weight identity is valued.
PMID:40097257 | DOI:10.1016/j.pec.2025.108652