How to practice weight-inclusive care as a health professional
If you work in the health, wellness, or fitness space, you've likely seen how weight is often treated as the sole indicator of health. But what if we took a more inclusive approach? Weight-inclusive care shifts the focus from weight loss to overall well-being, recognising that health comes in all shapes and sizes. Here’s how you can practice weight-inclusive care as a health professional and make a meaningful difference in the lives of your clients or patients.
What is Fatphobia?
Fatphobia is the irrational fear or hatred of fat bodies and people who are perceived as overweight. It’s a deeply ingrained societal bias that often leads to discrimination and negative stereotyping of individuals based on their body size. This fear and stigma can be subtle or overt, showing up in everyday language, media representation, and even in the attitudes of health professionals.
What is Fat Bias in Healthcare?
Fat bias in healthcare refers to the prejudiced attitudes and beliefs that some health professionals hold about individuals based on their body size. This bias can lead to substandard care, with healthcare providers attributing a wide range of health issues to a patient’s weight, often without proper assessment or consideration of other factors. For example, someone experiencing joint pain may be told to lose weight instead of receiving appropriate diagnostic tests or treatments. This bias can also discourage people from seeking care in the first place, leading to delayed diagnoses and worse health outcomes.
Examples of Fatphobia and Fat Bias in Healthcare
A patient with a higher BMI is told to lose weight as a first line of treatment, regardless of their presenting symptoms.
Medical equipment, like blood pressure cuffs or MRI machines, not being adequately sized for larger bodies, resulting in uncomfortable or inaccurate procedures.
Assumptions that all fat people are unhealthy or unfit, despite evidence that people of all sizes can achieve health through balanced nutrition, physical activity, and other health-promoting behaviors.
The Harmful Impacts of Fatphobia in Healthcare
Research shows that fatphobia in healthcare can have serious consequences. A study published in Obesity Reviews found that weight stigma is associated with increased stress, disordered eating behaviors, and avoidance of medical care . This stigma can lead to mental health issues such as anxiety and depression, as well as physical health problems due to delayed or inadequate treatment.
Moreover, fatphobia can reinforce a culture of shame, where people feel they must lose weight to be deserving of quality care, which only perpetuates a cycle of weight cycling (repeated dieting and weight regain) that is harmful to metabolic health and psychological well-being.
Is Obesity Harmful to Our Health?
Contrary to popular belief, not all cases of obesity are linked to poor health outcomes. Research suggests that individuals with grade 1 obesity (a BMI between 30 and 34.9) may not have a significantly increased risk of mortality compared to those with a "normal" BMI. In fact, a study published in the Journal of the American Medical Association (JAMA) found that individuals with grade 1 obesity did not have a higher risk of death from all causes compared to those with a BMI in the normal range . This finding challenges the notion that weight alone is a reliable indicator of health.
The Harmful Effects of Weight Cycling (From Dieting)
What’s often more harmful than maintaining a higher body weight is the phenomenon of weight cycling—repeatedly losing and regaining weight due to dieting. Weight cycling has been linked to a host of negative health outcomes, including increased risk of cardiovascular disease, insulin resistance, and higher levels of inflammation . It can also take a toll on mental health, leading to feelings of failure, shame, and a poor relationship with food and body image.
What is HAES® (Health At Every Size)?
Health At Every Size (HAES®) is an evidence-based framework that promotes the idea that people of all sizes can pursue health and well-being. The HAES® approach challenges the traditional weight-focused paradigm by emphasising behaviors that support health, such as intuitive eating, joyful movement, and emotional well-being, regardless of weight. It encourages healthcare providers to focus on health-promoting behaviors rather than weight loss, creating a more inclusive and supportive environment for all individuals.
How to Practice Weight-Inclusive Care as a Health Professional
Challenge Your Own Biases: Begin by reflecting on your own attitudes towards weight and body size. Consider how these beliefs might influence your interactions with clients or patients. Ongoing education and self-reflection are key to becoming a more weight-inclusive practitioner.
Focus on Health Behaviors, Not Weight: Encourage your clients or patients to adopt health-promoting behaviors—such as balanced nutrition, regular physical activity, and stress management—without tying these behaviors to weight loss. This shifts the focus to overall well-being, rather than a number on the scale.
Use Neutral Language: Avoid using language that implies weight loss is a moral or health obligation. Instead, use neutral or positive language that empowers clients or patients to make choices that support their well-being.
Provide Accessible Care: Ensure that your practice is accommodating to people of all sizes by having equipment that fits larger bodies and offering a judgment-free space where clients feel safe and respected.
Advocate for Change: Work to combat fatphobia and weight bias within your profession by advocating for weight-inclusive care practices and challenging discriminatory policies and behaviors when you see them.
By practicing weight-inclusive care, you can create a more supportive and effective environment for your clients or patients. Not only does this approach promote better health outcomes, but it also fosters a sense of respect, dignity, and inclusion for people of all sizes.
Be kind to yourself (and others)
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