Table 2 Final version of the 9-item checklist.

1. Providers/clinicians receive training about weight stigma and how weight stigma affects clinical consultations/interactions with clients. Training may be online or in-person and delivered by a recognised provider. A list of available resources for training can be found online at www.editcollaboration.com/resources:

Training should include:

a Debunking myths about weight regulation and understanding the complexity of obesity.

b How assumptions about people of higher weight affect the clinician-client relationship.

c Use of person-centered and non-stigmatising language.

d The importance of choosing and using appropriate weight-related terminology with the client.

2. Printed/distributed materials, online resources, apps, etc use non-stigmatising language (e.g., “person with obesity”, “person with higher weight”, “person living in a larger body”) and imagery. For example, imagery including people with a range of body sizes, remove images that exacerbate negative stereotypes, use available image libraries (see online resource guide). Resources to access non stigmatising images and information about language can be found online at www.editcollaboration.com/resources. Have materials co-designed by people with lived experience and clinicians to ensure they are appropriate.

3. Equipment and/or built environments have been adapted to safely and comfortably support people with diverse body sizes, where possible for in-person interventions, including the following options:

 • Scales are positioned in a private space, and have a high maximum weight capacity

 • Examination gown sizes (have many different gown sizes available to accommodate diverse body sizes).

 • Appropriate assessment tools, with diverse sizes (e.g., blood pressure cuffs that accommodate diverse arm circumferences, long measuring tape, wide examination tables that can support high weights).

 • Seating (having diverse chair widths available in the intervention setting, with and without arm rests; seating should support a high maximum weight capacity to safely and comfortably support diverse body weights).

 • Built environment accessibility (e.g., shorter distances from the parking lot to the intervention setting, availability of a lift/elevator -especially if staircases are not designed to be safe and/or support people with mobility challenges, wide spaces within the waiting room area and doorways, suitable toilet facilities that safely and comfortably support higher weight capacities).

 • Exercise equipment (e.g., fitness equipment and benches have high maximum weight capacity and width to safely and comfortably support people with diverse body weights and sizes).

4. Consider the context of weighing clients that includes (a) considering if weighing is necessary; (b) asking for consent before weighing, and (b) offering blind weighing (covering the number on the scale so it cannot be seen).

5 Provide person-centred care in line with the client’s personal health goals. This may include discussing and setting goals beyond those related to weight loss, and measuring/monitoring progress related to these goals. These may include simple questions that invite self-reflection or can be assessed using validated measures. For example, goals discussed may include one or more of the following areas:

 (a) Quality of life [e.g., physical function (mobility, being able to perform tasks), self-esteem, sexual life, work, social relationships]

 (b) Cardiometabolic health markers (e.g., fitness, glucose levels, blood pressure, etc.)

 (c) Fruit and vegetable intake

 (d) Physical activity and sedentary behaviour

 (e) Self- or body- compassion

 (f) Other goals

6. Assess mental health (e.g., depression, anxiety, disordered eating, body image), determine cutoffs that necessitate mental health support and plan/establish appropriate referral pathways.

7. Provide support to clients throughout the intervention to help them manage societal/external sources of weight stigma. This may include:

 (a) Training clients on communication skills that can help them with managing instances in which people in the client’s life want to engage in conversations about the person’s body weight (e.g., how to reframe conversations to focus on health instead of weight, how to say to others that their own weight is not up for discussion).

 (b) Providing guidance to a client’s social support networks (e.g., partner or parents/siblings/family unit, friends) on the negative effects of weight stigmatising language and treatment.

 (c) Providing clients with strategies to increase resilience and coping, so they are better able to deal with public/structural weight stigma as part of the intervention

8. Address weight bias internalisation (WBI). This term refers to the extent to which a person adopts and endorses negative attitudes/beliefs about people with higher weight and, as a result, devalues and stigmatizes themselves because of their weight. This may include:

 (a) Explaining what WBI is and how it could affect their behaviours and their physical and mental health

 (b) Measuring WBI (before, during and after treatment)

 (c) Screening for high levels of WBI and develop a plan to address this as part of the intervention.

9. Seek feedback from clients/ participants on whether they experienced weight stigma during the intervention, as a mechanism for quality improvement of future services and interventions.