Weight stigma in healthcare settings in Aotearoa (New Zealand): Pacific women’s voice

Pacific women’s accounts of weight stigma in healthcare settings highlight longstanding harms that have been overlooked within both health services and research. Internationally, weight stigma has been shown to contribute to many adverse health outcomes ranging from impact on clinical markers of health risk to healthcare avoidance (1) . Pacific women experience the compounded effects of weight stigma, racism and gender bias in healthcare, making their perspectives particularly important to understand (2) . This study aimed to explore their experiences of weight stigma in healthcare, its impact, and their recommendations for change from a Pacific perspective. Using the Talanoa research method (3) (a Pacific indigenous research methodology), 10 interviews were conducted with Pacific women aged 28–65 years who had experienced weight stigma in their interactions with health professionals. Talanoa was held face-to-face and guided by the principles of the Fonofale model to capture the multifaceted impact of this phenomenon (4) . Interviews were audio-recorded, transcribed automatically via Zoom, checked for accuracy, and then coded manually. A reflexive thematic analytic approach was used to identify key themes. Key themes generated relating to the weight stigma experienced by Pacific women in healthcare settings were (1) experiences of dismissal and stigma in healthcare (2) healthcare for women transcends clinical spaces, extending into family, cultural identity, spirituality and self-worth, (3) underlying systemic and interpersonal biases must be addressed (4) racism intersects with gender and weight stigma undermining trust in health professionals and (5) impacts of weight stigma on health behaviours. Pacific women’s stories highlight weight stigma as a structural issue, compounded by ethnicity and gender, that undermines equitable healthcare. The women of this study recommend that to address this healthcare professionals receive meaningful cultural safety training in recognising and addressing weight bias, to ensure respectful and culturally safe care for Pacific peoples.