Overcoming Weight Bias and Stigma

In the fourth and final video of this series, PA Joseph Zucchi examines weight bias and stigma, which are as common among healthcare providers as in the general population. He explains the difference between explicit and implicit bias and describes how bias in healthcare can lead to less patient-centered communication, missed screenings, and poorer mental and physical health outcomes.

PA Zucchi offers practical steps PAs can take, including self-reflection, recognizing obesity as a disease, and using patient-first language.

Key Takeaways:

Weight bias and stigma in healthcare have significant impact on patient outcomes.
Use patient-first language and ask permission to discuss weight.
Evaluate your practice for office items that are not weight-inclusive.

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Speaker

Click on the photo below to learn more about the speaker.

Joseph Zucchi, PA-C, MPAS

References and Additional Resources:

Ferrante JM, Piasecki AK, Ohman-Strickland PA, Crabtree BF. Family physicians’ practices and attitudes regarding care of extremely obese patients. Obesity (Silver Spring). 2009;17(9):1710-1716. https://pubmed.ncbi.nlm.nih.gov/19282824/

Foster GD, Wadden TA, Makris AP, et al. Primary care physicians’ attitudes about obesity and its treatment. Obes Res. 2003;11(10):1168-1177. https://pubmed.ncbi.nlm.nih.gov/14569041/

Hebl MR, Xu J. Weighing care: physicians’ reactions to the size of a patient. Int J Obes Relat Metab Disord. 2001;25(8):1246-1252. https://pubmed.ncbi.nlm.nih.gov/11477511/

Obesity Action Coalition. Resource Library. Accessed September 17, 2026. https://www.obesityaction.org/library

Phelan SM, Dovidio JF, Puhl RM, et al. Implicit and explicit weight bias in a national sample of 4,732 medical students: the medical student CHANGES study. Obesity (Silver Spring). 2014;22(4):1201-1208. https://pubmed.ncbi.nlm.nih.gov/24375989/

Phelan SM, Burgess DJ, Yeazel MW, Hellerstedt WL, Griffin JM, van Ryn M. Impact of weight bias and stigma on quality of care and outcomes for patients with obesity. Obes Rev. 2015;16(4):319-326. https://pubmed.ncbi.nlm.nih.gov/25752756/

Puhl R, Brownell KD. Bias, discrimination, and obesity. Obes Res. 2001;9(12):788-805. https://pubmed.ncbi.nlm.nih.gov/11743063/

Puhl RM, Brownell KD. Confronting and coping with weight stigma: an investigation of overweight and obese adults. Obesity (Silver Spring). 2006;14(10):1802-1815. https://pubmed.ncbi.nlm.nih.gov/17062811/

Puhl RM, Phelan SM, Nadglowski J, Kyle TK. Overcoming weight bias in the management of patients with diabetes and obesity. Clin Diabetes. 2016;34(1):44-50. https://pubmed.ncbi.nlm.nih.gov/26807008/

Sabin JA, Marini M, Nosek BA. Implicit and explicit anti-fat bias among a large sample of medical doctors by BMI, race/ethnicity and gender. PLoS One. 2012;7(11):e48448. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0048448

Supported by

Joseph Zucchi, PA-C, MPAS

Joseph Zucchi is the Clinical Supervisor and physician associate at Transition Medical Weight Loss in Salem, New Hampshire, where he leads a multidisciplinary obesity medicine program dedicated to comprehensive care. Under his clinical leadership, Transition has helped patients achieve more than 60,000 pounds of collective weight loss while making meaningful improvements in their health.

PA Zucchi serves on the board of the New England Obesity Society and as a clinical preceptor for physician associate students at MCPHS University. He is also a national speaker and advisor in obesity medicine, educating healthcare professionals on obesity as a chronic disease, anti-obesity medications, cardiometabolic health, and strategies to improve patient outcomes.

A passionate advocate for people living with obesity, PA Zucchi is actively involved in efforts to improve treatment access, advance obesity care, and challenge the stigma and misconceptions surrounding the disease. He has authored numerous articles and op-eds, appeared on podcasts and professional educational programs, and his expertise has been featured in The Wall Street Journal, The New York Times, Bloomberg, USA Today, Forbes Health, Medscape, The Boston Globe, and other national media.