Background: More than a third of people in Austria are considered overweight and around 17% as obese based on the body mass index. Around half of these people are affected by weight stigmatisation, the cultural devaluation because of their body weight. The healthcare sector is cited as the most common cause of weight stigmatisation, which can result in patients affected by incorrect or no diagnoses and treatments, avoided examinations and health consequences such as further weight gain. Against this background, the aim of this report was to identify recommendations for reducing weight stigmatisation in the healthcare sector (research question 1) and to assess the effectiveness of interventions (research question 2).

Methods: One systematic literature search was conducted for both research questions. Guidelines and systematic reviews were included to identify proposed strategies, and quantitative as well as qualitative studies were included to assess interventions. The quality of the primary studies was assessed with different tools depending on the study design.

Results: A total of 26 sources were identified for the first research question. The numerous recommendations related to healthcare staff and students, patients, structural measures and policy strategies. A total of 30 primary studies were included for answering the second research question. Multi-day or multi-week courses for healthcare professionals or students showed the strongest evidence for a positive effect on weight stigma. One-day courses also showed positive effects, e.g. on internalised weight biases in patients, and beliefs and explicit weight biases in healthcare professionals. Studies reported statistically significant improvements in explicit weight biases and self-confidence of medical students when treating patients after roleplay exercises, but no significant improvements in weight stigma after watching informative videos. The effects of simulations or meditations were controversial in the identified studies. Among those affected, there were significant improvements in internalised weight biases after group courses, supportive self-help courses and informative videos.

Conclusion: The most evidence with the strongest indications was found for multi-day training programmes for healthcare staff and students. This strategy is also recommended in guidelines. At the same time, some interventions with evidence for positive effects were not represented in guidelines to date (e.g. roleplays, meditation), while there was no evidence for some recommended strategies (e.g., recommendations for stigma-free communication and language). When interpreting the results, the methodological limitations of the included studies, the transferability of the international evidence to the Austrian context and possible negative consequences of interventions should be considered. In addition, studies on the prevalence of weight stigma, its effects and the acceptance and applicability of interventions in Austria are necessary.