# Patient Perspectives on Impact of Weight and Weight Stigma on Breast and Cervical Cancer Treatment: A Qualitative Study

## TL;DR

This study explores how weight and weight stigma affect breast and cervical cancer treatment experiences for higher weight patients.

## Contribution

The study provides new insights into weight-based stigma during cancer treatment through qualitative interviews with higher weight cancer survivors.

## Key findings

- Most participants reported positive cancer treatment experiences unrelated to weight.
- Some experienced weight stigma that led to delayed diagnoses or treatment changes.
- Participants often did not perceive weight-related discussions as stigmatizing if framed as health concerns.

## Abstract

Higher weight individuals report experiencing weight‐based stigma in the healthcare setting; within the cancer continuum, the most robust evidence exists for cancer screening. More research is needed to understand whether and how higher weight patients experience weight stigma during cancer treatment.

We conducted semi‐structured interviews with 15 breast and 15 cervical cancer survivors diagnosed 2017–2019 in Iowa who had a pre‐diagnosis body mass index of 30+ kg/m2 calculated from their driver's license height and weight. Interviews focused on whether individuals perceived being treated differently because of their weight in daily life, in healthcare, or during cancer treatment. Data were coded using a combination of inductive and deductive approaches, and analyzed using a multi‐phase thematic analysis.

Almost all interviewees reported positive experiences during cancer treatment; several described their weight as never being an issue. Some identified weight stigma during cancer diagnosis or treatment that resulted in delayed diagnoses or changes in treatment. Many interviewees described situations where their weight was discussed negatively during cancer treatment, but most did not identify these as stigmatizing because their providers were only “concerned about [their] health.” Additional themes developed included experiencing environmental stigma, the discussion of cancer recurrence by providers only as it related to weight, and misconceptions of the causes and consequences of obesity.

While several participants did not feel that their weight impacted cancer treatment, some reported experiences of weight stigma pre‐diagnosis and during treatment. When individuals noted their weight was discussed during treatment, internalized bias may have impacted whether they considered these discussions stigmatizing.