Examining the impact of identity-safety cues on inclusion for adults with higher body weights in healthcare settings

Abstract

Objectives

Adults with higher body weights experience weight stigma in healthcare, which can heighten concerns about treatment in these settings. This study investigates whether a specific strategy—using an identity-safety cue, or a cue which signals that one’s social identity is valued—mitigates these concerns.

Methods

527 U.S. adults who self-identified as overweight were randomized to read about a hypothetical physician who endorsed a weight-inclusive clinical approach (identity-safety cue condition) or making health information accessible (control condition). Next, participants read a vignette where the physician attributed their persistent knee pain to their age (control diagnosis), lifestyle habits (ambiguous diagnosis), or body weight (stigmatizing diagnosis).

Results

Exposure to the physician who employed the identity-safety (versus control) cue decreased weight stigma concerns, increased perceptions of physician allyship, and promoted identity-safety. While use of the identity-safety cue elicited benefits regardless of the physician’s clinical diagnosis, viewing the identity-safety cue alongside the stigmatizing diagnosis increased perceptions that the physician’s commitment to diversity was dishonest, which subsequently harmed feelings of safety.

Conclusions

Use of identity-safety cues in healthcare can effectively promote inclusion for adults with higher body weights. However, perceiving that the physician’s pro-diversity efforts are dishonest can undermine inclusion.

Practice implications

To effectively promote inclusion for adults with higher body weights, physicians should employ cues which explicitly signal that their weight identity is valued.