How Does Weight Stigma Impact Healthcare Settings? Evidence From Chilean Patients Seeking Healthcare.

INTRODUCTION: Weight stigma in healthcare settings refers to the prejudiced devaluation of individuals with higher body weight, often manifested through causal attribution comments. This stigma reflects a complex interplay of psychological and behavioral processes that may contribute to outcomes such as medical avoidance. OBJECTIVE: To determine whether weight stigma in healthcare settings is directly associated with internalized weight stigma, uncontrolled eating, and medical avoidance, and whether these associations are mediated through a serial pathway culminating in healthcare avoidance. METHOD: A cross-sectional study was conducted with 309 healthcare users in Chile (Mage = 37.72 years; SD = 15.68; 75% women), using self-report measures and structural equation modeling. RESULTS: All direct effects were significant, except for the path between weight stigma and uncontrolled eating. The serial mediation via internalized weight stigma and uncontrolled eating was supported (βindirect = 0.041, p 0.046; 12.06% of the total effect), as was the simple mediation via internalized stigma alone (βindirect = 0.071, p = 0.048; 20.88%). Mediation through uncontrolled eating alone was not significant (βindirect = 0.013, p = 0.239). The total effect of weight stigma in healthcare settings on medical avoidance was significant (βTotal = 0.340, p < 0.001; 63.24%). The model demonstrated good fit indices. CONCLUSION: Weight stigma in healthcare settings negatively impacts psychological and behavioral health. Addressing weight stigma is essential to reducing avoidance behaviors and improving continuity of care. These findings highlight the importance of implementing public policy reforms and providing training for healthcare professionals.