Body Shame Predicts Healthcare Discomfort and Avoidance in College Women Through the Mechanism of Low Body Responsiveness

Background: Many cultures promote ideals for women's bodies that are difficult to meet, and not meeting these ideals may result in body shame. Body shame predicts discomfort in and avoidance of situations in which the body may be scrutinized. As the healthcare setting frequently involves examination of the body, body shame may predict discomfort in and avoidance of the healthcare setting. However, these relationships have been tested minimally and only in higher-weight women. Since body shame may occur regardless of BMI, body shame may predict healthcare discomfort and avoidance across the weight spectrum. Moreover, these relationships may occur because body shame predicts low body responsiveness, or the detection and valuing of bodily signals, which in turn may predict healthcare discomfort and avoidance.

Method: The present investigation tested these ideas in weight-diverse undergraduate women (N = 467) using cross-sectional (studies 1 and 2) and experimental (study 3) designs and imagined healthcare settings.

Results: In study 1, body shame correlated positively with healthcare discomfort, and low body responsiveness mediated this relationship. In study 2, body shame was not directly related to healthcare avoidance, but low body responsiveness mediated this relationship. In study 3, participants who underwent a body shame induction reported lower state body responsiveness than control participants, and lower state body responsiveness mediated the links between condition and healthcare discomfort and avoidance.

Conclusion: Attitudes toward internal bodily functions may link body shame to healthcare avoidance and discomfort in college women across the weight spectrum. Future research may examine this model in more diverse populations.