Impact of Perceived Weight Stigma among Underserved Women on Doctor-Patient Relationships.
OBJECTIVE
To evaluate how perception of weight stigma among underserved women with obesity impacts doctor-patient relationships.


METHODS
This study consisted of an interviewer-administered survey of 149 women with obesity (BMI ≥ 30 kg/m2) immediately after their physician visit at four Federally Qualified Health Centers. Perceptions of weight stigma and physician empathy were measured using the Stigma Situations in Health Care instrument and Consultation and Relational Empathy (CARE) measure, respectively. Associations of CARE and Stigma scores with BMI and patient characteristics were analyzed using Mantel-Haenszel chi-square test and ordinal logistic regression.


RESULTS
The mean CARE score was 42.1 (sd 8.4; range 11.0-50.0) and mean Stigma score was 4.6 (sd 7.6; range 0-43.0). Each increase in BMI category was associated with almost 2-fold increased odds of higher perception of Stigma (OR, 1.90, 95% CI 1.30-2.78, p=0.001). BMI was not associated with CARE. However, for each increase in stigma category, the odds of lower CARE score doubled (OR, 0.52, 95% CI 0.36-0.75, p=0.0005).


CONCLUSIONS
While BMI was not associated with perception of physician empathy, higher frequency of weight stigmatizing situations was negatively associated with perception of physician empathy. Reducing weight stigma in primary care could improve doctor-patient relationships and quality of care in patients with obesity.
Department of Family Medicine and Community Health, Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA; Rutgers-Cancer Institute of New Jersey, New Brunswick, New Jersey, USA.
Jeanne M
JM
Ferrante
Preliminary Medicine, Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.
KelliAnn
K
Seaman
Department of Family Medicine and Community Health, Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.
Alicja
A
Bator
Department of Family Medicine and Community Health, Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA; Rutgers-Cancer Institute of New Jersey, New Brunswick, New Jersey, USA; Department of Biostatistics, Rutgers-School of Public Health, Piscataway, New Jersey, USA.
Pamela
P
Ohman-Strickland
Department of Family Medicine and Community Health, Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA; Rutgers-Cancer Institute of New Jersey, New Brunswick, New Jersey, USA.
Daniel
D
Gundersen
Department of Family Medicine and Community Health, Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.
Lynn
L
Clemow
Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, Connecticut, USA.
Rebecca
R
Puhl
minorities; obesity; patient-provider communication; primary care; weight stigma