Developing Expert Consensus on How to Address Weight Stigma in Public Health Research and Practice: A Delphi Study

Some public health practices, especially those focused on weight loss, have been found to increase weight stigma, which is harmful to physical and mental health. We used the Delphi method to establish expert consensus on how to address weight stigma in public health. Our participants were recruited from a convenience sample of individuals attending a single-day symposium on public health prevention of eating disorders, though they reported having high levels of formal (education, employment) and informal (advocacy, lived experience in eating disorders) expertise, all of which was relevant to weight stigma. Three online surveys were completed by 88 experts. Of the 177 ideas presented, 68 were endorsed and 109 were rejected. Experts reached consensus on an array of topics: cross-disciplinary collaboration, the need for inclusivity and diversity, defining how weight stigma arises in research and practice, and advocating for change in popular culture and industry. Experts also agreed on the need to shift focus away from body weight toward health behaviors; however, they did not reach consensus on how to make that shift. Although this study requires replication with a larger and more diverse sample of experts, these initial outcomes provide clear recommendations for changes in public health research, practice, and policy, and highlight areas for further research.