Navigating the American Healthcare System as an Obese Person: Developing Effective Community-Based Treatment Strategies for Healthcare Providers

Date of Award

Spring 2015

Author Requested Restriction

Open Access (no embargo, no restriction)

Work Type

Masters Thesis

Degree Name

Master of Arts in Interdisciplinary Studies (MAIS)


Interdisciplinary Arts and Sciences

First Advisor

Lawrence Knopp

Second Advisor

Ariana Ochoa Camacho


Obesity is a public health concern associated with increased medical costs and poorer health outcomes, but it is also associated with minority status and this social context has important healthcare implications. Ten interviews were conducted in the Tacoma, WA area to identify common weight-loss barriers, and health literacy and agency emerged as factors that impact health outcomes. Health literacy interacted with both the healthcare system and the weight-loss industry, as interviewees indicated a lack of distinction between the two. Some interviewees indicated that bias and stigma overrode health literacy, an act referred to as bias-associated suppression of health literacy (BASH). Agency impacted the patient-provider relationship and access to community resources, and can be considered an aspect of structural competence. Some scholars have argued for including structural competence in professional health education to improve patient outcomes. Structural competence education and improved patient health literacy may both improve patient health outcomes.