Weight Bias and Stigma
People living with obesity often experience judgement, assumptions or differential treatment based
on their body size. These experiences, whether subtle or overt, are forms of weight bias and stigma
and they remain widespread across all areas of healthcare, including physiotherapy. Importantly, weight stigma is not simply a matter of insensitive language or attitudes; it is a measurable health risk that can negatively affect clinical outcomes, diagnostic accuracy, therapeutic relationships, and long-term engagement with care.
Dr Fiona Curran and Dr Gráinne O’Donoghue, are physiotherapists and researchers at University College Dublin whose work focuses on obesity, weight stigma and equitable models of healthcare. Drawing on this clinical and research expertise, they have devised an evidence-based educational video series
to support physiotherapists and all healthcare professionals in delivering care that is safe, equitable,
and free from weight-based stigma.
This educational video series, OSE4ALL (Obesity Stigma Education 4 All) recognises obesity as a complex, chronic condition shaped by a wide range of biological, psychological, social, and environmental factors, far beyond individual behaviour alone. When stigma influences how obesity is understood
or discussed, it can result in incomplete assessment, missed or delayed diagnoses, restricted treatment options, and reduced trust between patients and clinicians. Understanding and addressing weight stigma is a key professional responsibility in healthcare.
What these educational videos cover?
This video series contains four interconnected units. Together, they provide the knowledge, awareness and practical tools needed to reduce weight stigma and deliver compassionate, evidence-based, person-centred care.
Unit 1: Obesity as a Chronic Disease
In unit 1, obesity is established as a chronic, relapsing disease rather than a personal failing or simple lifestyle choice. The unit examines the biological systems regulating body weight, as well as the social and environmental factors that influence obesity, supporting a shift from blame-based narratives to understanding.
Unit 2: Recognising Weight Stigma and Bias in Practice
Unit 2 focuses on identifying weight stigma, weight bias and weight discrimination in healthcare settings. You will reflect on how stigma, both personal and systemic, can influence clinical judgement, communication and treatment decisions, often without conscious awareness.
Unit 4: Competent, Patient-Centred Care
In the final unit, unit 4, clinical frameworks and practical tools are brought together to support high-quality care for people living with obesity. This includes the tiered model of care (based on the Irish system), multimodal treatment approaches, application of the 4Ms framework, and delivering stigma-free care, even when patients present for non-obesity related concerns. The unit also highlights the role of healthcare professionals in advocating for an equitable, stigma-free healthcare system.
A Final Reflection
Destigmatising obesity does not mean avoiding conversations about weight or its health implications. Rather, it means approaching each person with curiosity rather than assumption, using respectful, evidence-informed communication and ensuring that care is guided by the individual’s goals, values
and full health picture, not by stereotypes.
We encourage you to engage with this video series reflectively and consider how your language, assumptions and clinical practices can profoundly shape patient experiences and outcomes.
This resource was developed by the PROMINENCE Team members: Dr Fiona Curran and Dr Gráinne O’Donoghue, University College Dublin, Ireland.
Additional Resources
In addition to this educational video and its referenced materials, further learning is available through the websites listed below. These sources are scientifically grounded, evidence-informed and developed by reputable organisations and experts. They provide reliable, up-to-date information to support understanding, reflection and best practice in addressing weight bias and stigma in healthcare.
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Association for the Study of Obesity on the Island of Ireland:
Reducing Weight Bias in Obesity Management, Practice, & Policy
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Obesity Canada:
Weight Bias, Stigma & Discrimination
This resource was developed by Obesity Canada and is shared with permission for inclusion in the PROMINENCE Open Education Resource (OER). For more information, visit: obesitycanada.ca.
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World Obesity Federation:
Weight Stigma
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European Association for the Study of Obesity:
Person First Language Guide: Addressing Weight Bias
This resource was developed by the European Association for the Study of Obesity (EASO), and is shared with permission for inclusion in the PROMINENCE Open Education Resource (OER). For more information, visit easo.org.