{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T05:11:04Z","timestamp":1788757864901,"version":"build-2803163510"},"reference-count":70,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T00:00:00Z","timestamp":1788652800000},"content-version":"vor","delay-in-days":248,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100020884","name":"Agencia Nacional de Investigaci\u00f3n y Desarrollo","doi-asserted-by":"publisher","award":["21241321"],"award-info":[{"award-number":["21241321"]}],"id":[{"id":"10.13039\/501100020884","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005916","name":"Universidad de La Frontera","doi-asserted-by":"publisher","award":["TD23-0011"],"award-info":[{"award-number":["TD23-0011"]}],"id":[{"id":"10.13039\/501100005916","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Obesity"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Weight stigma in healthcare settings refers to the prejudiced devaluation of individuals with higher body weight, often manifested through causal attribution comments. This stigma reflects a complex interplay of psychological and behavioral processes that may contribute to outcomes such as medical avoidance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine whether weight stigma in healthcare settings is directly associated with internalized weight stigma, uncontrolled eating, and medical avoidance, and whether these associations are mediated through a serial pathway culminating in healthcare avoidance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>\n                      A cross\u2010sectional study was conducted with 309 healthcare users in Chile (M\n                      <jats:sub>age<\/jats:sub>\n                      \u2009=\u200937.72\u2009years; SD\u2009=\u200915.68; 75% women), using self\u2010report measures and structural equation modeling.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      All direct effects were significant, except for the path between weight stigma and uncontrolled eating. The serial mediation via internalized weight stigma and uncontrolled eating was supported (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      <jats:sub>indirect<\/jats:sub>\n                      \u2009=\u20090.041,\n                      <jats:italic>p<\/jats:italic>\n                      0.046; 12.06% of the total effect), as was the simple mediation via internalized stigma alone (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      <jats:sub>indirect<\/jats:sub>\n                      \u2009=\u20090.071,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.048; 20.88%). Mediation through uncontrolled eating alone was not significant (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      <jats:sub>indirect<\/jats:sub>\n                      \u2009=\u20090.013,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.239). The total effect of weight stigma in healthcare settings on medical avoidance was significant (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      <jats:sub>Total<\/jats:sub>\n                      \u2009=\u20090.340,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001; 63.24%). The model demonstrated good fit indices.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Weight stigma in healthcare settings negatively impacts psychological and behavioral health. Addressing weight stigma is essential to reducing avoidance behaviors and improving continuity of care. These findings highlight the importance of implementing public policy reforms and providing training for healthcare professionals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/jobe\/9983925","type":"journal-article","created":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T04:21:19Z","timestamp":1788754879000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["How Does Weight Stigma Impact Healthcare Settings? Evidence From Chilean Patients Seeking Healthcare"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5053-6693","authenticated-orcid":false,"given":"Fernanda","family":"Bast\u00edas-Gonz\u00e1lez","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4407-0567","authenticated-orcid":false,"given":"Daniela","family":"G\u00f3mez-P\u00e9rez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,6]]},"reference":[{"key":"e_1_2_10_1_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41574-019-0176-8"},{"key":"e_1_2_10_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/J.AMEPRE.2022.01.030"},{"key":"e_1_2_10_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(24)00316-4"},{"key":"e_1_2_10_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12529-020-09917-1"},{"key":"e_1_2_10_5_2","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1093\/oxfordhb\/9780190243470.013.27","volume-title":"The Oxford Handbook of Stigma, Discrimination, and Health","author":"Major B.","year":"2017"},{"key":"e_1_2_10_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.appet.2014.06.108"},{"key":"e_1_2_10_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40519-016-0304-6"},{"key":"e_1_2_10_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/oby.20910"},{"key":"e_1_2_10_9_2","article-title":"Obesity Stigma: Prevalence and Impact in Healthcare","author":"Flint S.","year":"2015","journal-title":"British Journal of Obesity"},{"key":"e_1_2_10_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/obr.13185"},{"key":"e_1_2_10_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/hex.14098"},{"key":"e_1_2_10_12_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41366-021-00860-z"},{"key":"e_1_2_10_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/J.BODYIM.2018.03.001"},{"key":"e_1_2_10_14_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41366-021-00982-4"},{"key":"e_1_2_10_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/OSP4.379"},{"key":"e_1_2_10_16_2","doi-asserted-by":"publisher","DOI":"10.1093\/abm\/kaae044"},{"key":"e_1_2_10_17_2","doi-asserted-by":"publisher","DOI":"10.1111\/obr.12701"},{"key":"e_1_2_10_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.appet.2016.01.034"},{"key":"e_1_2_10_19_2","doi-asserted-by":"publisher","DOI":"10.1111\/ejn.14352"},{"key":"e_1_2_10_20_2","doi-asserted-by":"publisher","DOI":"10.1002\/eat.22835"},{"key":"e_1_2_10_21_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41366-022-01233-w"},{"key":"e_1_2_10_22_2","doi-asserted-by":"publisher","DOI":"10.1111\/OBR.12266"},{"key":"e_1_2_10_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnesp.2021.09.746"},{"key":"e_1_2_10_24_2","doi-asserted-by":"publisher","DOI":"10.1111\/OBR.13494"},{"key":"e_1_2_10_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnsa.2025.100306"},{"key":"e_1_2_10_26_2","doi-asserted-by":"publisher","DOI":"10.1037\/SAH0000578"},{"key":"e_1_2_10_27_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40519-018-0540-z"},{"key":"e_1_2_10_28_2","volume-title":"Principles and Practice of Structural Equation Modeling","author":"Kline R.","year":"2016"},{"key":"e_1_2_10_29_2","doi-asserted-by":"publisher","DOI":"10.1177\/0013164413495237"},{"key":"e_1_2_10_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/J.CPR.2022.102127"},{"key":"e_1_2_10_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/J.BETH.2022.12.003"},{"key":"e_1_2_10_32_2","doi-asserted-by":"publisher","DOI":"10.1002\/OSP4.40"},{"key":"e_1_2_10_33_2","doi-asserted-by":"crossref","first-page":"3186","DOI":"10.1097\/00007632-200012150-00014","article-title":"Guidelines for the Process of Cross-Cultural Adaptation of Self-Report Measures","volume":"25","author":"Beaton D. 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