Abstract
Fat people, and particularly fat women, face pervasive and salient stigma in healthcare contexts, resulting in downstream health disparities. We investigated whether a representational identity safety cue could mitigate experiences of threat and stigma, and prompt feelings of belonging. In two preregistered studies with fat women samples (N = 1512), we manipulated physician demographics to examine the function of physician concordance as an identity safety cue. Target physicians varied on gender (woman, man) and body size (fat, thin); Study 2 incorporated an additional factor of physician race (Black, White). We examined how these physician characteristics shaped outcomes, including anticipated weight stigma, belonging, and anxiety. Fat doctors consistently elicited less anticipated weight stigma than thin doctors, suggesting that doctor body size can serve as an identity safety cue for fat patients. Gender, however, appeared to be a more salient safety cue than body size, with fat women consistently reporting greater identity-safety expectations from women doctors relative to men doctors. Black physicians, relative to White physicians, elicited more favorable expectations of belonging, comfort, anxiety, warmth, and competence—though did not elicit decreased weight stigma concerns. Overall, physician diversity in body size, gender, and race strengthened belonging and decreased weight stigma concerns.
Public Significance Statement
Fat women experience health disparities due to weight stigma. We found that fat doctors reduced stigma concerns among fat women. Fat women also anticipated better experiences with Black and women doctors than those who were White and men. Doctor body size, race, and gender can signal safety for fat patients; Policies that expand diversity, equity, and inclusion in medical training and in the medical workforce could reduce disparities.