Term of Award

Spring 2025

Degree Name

Doctor of Public Health in Community Health Behavior and Education (Dr.P.H.)

Document Type and Release Option

Dissertation (open access)

Copyright Statement / License for Reuse

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.

Department

Department of Health Policy and Community Health

Committee Chair

Nandi A. Marshall

Committee Member 1

Andrew Hansen

Committee Member 2

Stacy W. Smallwood

Committee Member 3

Paige Ziegler

Abstract

Weight stigma and weight bias have significant effects on the health of individuals (Alberga et al., 2019; Pearl, 2018; Puhl & Heuer, 2010; Schwartz et al., 2003; Udo et al., 2016). These biases can show up in the form of fatphobia or anti-fat bias. Physicians who hold anti-fat bias can affect their relationship with their patients, leading to poorer health outcomes and worse patient experiences for larger-bodied and fat people (Phelan et al., 2015). The purpose of this study is to contribute to the current literature regarding the positive and negative experiences of fat patients with a fat liberation praxis when they receive medical care; the barriers faced when they seek medical care; how these barriers affect their overall well-being positively and negatively; and what recommendations these patients have for improvement. The study employed the Health Stigma and Discrimination Framework to understand the stigmatization process regarding medical fatphobia throughout the multiple spheres of influence informed by the Social Ecological Model. Photovoice was used to document fat patients’ experiences, the barriers they face, and recommendations. Fifteen participants submitted a total of 112 photos with captions. A total of eight focus groups were held to discuss the photos and captions using the SHOWeD method. The photos, their captions, and the focus groups revealed the need for supportive, compassionate medical systems and providers. Participants noted the importance of medical providers providing weight-neutral, empathetic, patient-centered care. They also discussed the role of power in the interactions with their providers that could possibly influence treatment and health outcomes. Additionally, the participants spoke on the influence that the environment, culture, and society have on their overall health and the medical system itself. The participants recommended shifts in the medical system away from weight-centered care, the dismantling of fatphobia in US culture and society, advocacy, allyship, and increased accessibility for all persons.

Research Data and Supplementary Material

No

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