When stigma is the norm: How weight and social norms influence the healthcare we receive

This research seeks to broaden our understanding of weight stigma and discrimination in healthcare by exploring the influence of social norms on the treatment of higher-weight individuals. We conducted two experimental studies to investigate: (a) how health professionals' treatment decisions are influenced by patient weight; (b) the effect of norms that endorse weight stigma on health professionals' treatment decisions for patients of different weights; and (c) how these norms may operate differently within healthcare, compared with the general public. Practising health professionals (Study 1; N = 243) and laypeople (Study 2; N = 242) were randomly assigned to view the medical profile of either an average-weight or higher-weight patient who was seeking health care for migraines. Study 1 revealed that health professionals tended to treat the higher-weight patient for both their presenting condition and their weight. Health professionals who perceived weight stigma to be more normative among their colleagues displayed a hyper-vigilance toward weight, treating weight significantly more among both higher-weight and average-weight patients than those who perceived weight stigma to be less normative. Study 2 found that, unlike health professionals, laypeople treated the higher-weight patient for their weight at the expense of the presenting condition; and such differential treatment was inflated among those who perceived weight stigma to be the norm. The present research found clear evidence of bias in health professionals' treatment decision making—particularly for patients with larger bodies. However, unlike laypeople, this bias did not come at the expense of treating the presenting problem.