title: Physiotherapists demonstrate weight stigma: a cross-sectional survey of Australian physiotherapists.
abstract: OBJECTIVE
  Do physiotherapists demonstrate explicit and implicit weight stigma?
  
  
  METHODS
  Cross-sectional survey with partial blinding of participants. PARTICIPANTS responded to the Anti-Fat Attitudes questionnaire and physiotherapy case studies with body mass index (BMI) manipulated (normal or overweight/obese). The Anti-Fat Attitudes questionnaire included 13 items scored on a Likert-type scale from 0 to 8. Any score greater than zero indicated explicit weight stigma. Implicit weight stigma was determined by comparing responses to case studies with people of different BMI categories (where responses were quantitative) and by thematic and count analysis for free-text responses.
  
  
  METHODS
  Australian physiotherapists (n=265) recruited via industry networks.
  
  
  RESULTS
  The mean item score for the Anti-Fat Attitudes questionnaire was 3.2 (SD 1.1), which indicated explicit weight stigma. The Dislike (2.1, SD 1.2) subscale had a lower mean item score than the Fear (3.9, SD 1.8) and Willpower (4.9, SD 1.5) subscales. There was minimal indication from the case studies that people who are overweight receive different treatment from physiotherapists in clinical parameters such as length of treatment time (p=0.73) or amount of hands-on treatment (p=0.88). However, there were indications of implicit weight stigma in the way participants discussed weight in free-text responses about patient management.
  
  
  CONCLUSIONS
  Physiotherapists demonstrate weight stigma. This finding is likely to affect the way they communicate with patients about their weight, which may negatively impact their patients. It is recommended that physiotherapists reflect on their own attitudes towards people who are overweight and whether weight stigma influences treatment focus.
authors.affiliation: School of Psychology, The University of Queensland, Australia.
authors.forename: Jenny
authors.initials: J
authors.lastname: Setchell
authors.affiliation: School of Psychology, The University of Queensland, Australia.
authors.forename: Bernadette
authors.initials: B
authors.lastname: Watson
authors.affiliation: School of Applied Psychology, Griffith University, Australia.
authors.forename: Liz
authors.initials: L
authors.lastname: Jones
authors.affiliation: School of Education, Southern Cross University and School of Human Movement Studies, The University of Queensland, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Gard
authors.affiliation: School of Physiotherapy and Exercise Science, Curtin University, Australia.
authors.forename: Kathy
authors.initials: K
authors.lastname: Briffa
mesh_terms: D000328:Adult; D001294:Attitude to Health; D001315:Australia; D001835:Body Weight; D003430:Cross-Sectional Studies; D005260:Female; D058015:Health Communication; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000523:psychology*; D059825:Physical Therapists / Q000523:psychology*; D057545:Social Stigma; D013240:Stereotyping; D011795:Surveys and Questionnaires
keywords: Body weight; Ethics; Obesity; Physical therapists; Social stigma; Stereotyping