First do no harm: reconsidering our approach to weight in primary care

INTRODUCTION

Weight stigma may be defined as ‘the social devaluation, denigration, and marginalization of’ higher-weight individuals. ’¹ Weight stigma is well documented in the healthcare context, including in general practice, with implicit and explicit anti-fat biases consistently found in primary care physicians and serious implications for quality of care and patient outcomes.² Weight stigma is not only directed at patients. As a higher-weight doctor in the UK, I (Sebastian CK Shaw), have experienced numerous incidents of being publicly shamed or pointed to as a cautionary tale by colleagues in both primary and secondary care settings. Such experiences are validated by the recent findings from a North American study, in which 87% of doctors were found to harbour implicit anti-fat bias where higher-weight colleagues were concerned. Interestingly, when asked explicitly, most participants reported low levels of bias toward higher-weight doctors, suggesting that many may be unaware of their biases.³