Weight stigma is rampant in healthcare because many medical professionals are trained to take a weight-centered approach to treating their patients. This bias can have damaging and lasting effects on patients’ mental and physical health. When a doctor sees weight as an issue, it’s possible that they could miss important symptoms of illness. Patients who are told to lose weight might turn to dangerous methods like pills and restrictive diets, which can lead them to develop eating disorders. Experiencing weight-based discrimination might even lead patients to avoid doctor’s appointments altogether. That’s why it is critical that medical professionals are aware of weight bias and its impacts, especially on those living in larger bodies.
Though the Health at Every Size® (HAES) movement has grown since the publication of Dr. Lindo Bacon’s groundbreaking book in 2008, unfortunately the medical community is slow to adopt the principles all across the board. As a patient, it’s important that you know that your weight does not define your health, even if your doctor seems to think so.
If you go in for an appointment and are told that you need to lose weight, don’t turn to Weight Watchers for help. Advocate for a more holistic examination and explore the options for a different approach to your health. Here’s how:
Ask about other health factors
Gather more information about your health. If your vitals have been taken, ask about them. If not, request to have them done. If you’ve had any lab work done recently, discuss your results. If you haven’t, ask the doctor if they would recommend getting labs done to rule out possible concerns that have come up because of your weight.
Get a second opinion
A doctor who is relying on BMI to determine your health care may not be the best fit for you. Use this directory to find a medical professional who believes in Health At Every Size. If your doctor tells you to lose weight as a part of your treatment, ask them if this is the same advice they would give to someone in a smaller body with the same medical concern or issue.
Find a HAES-aligned dietitian
If there’s concern about your eating habits, consider setting up an appointment with a dietitian who doesn’t focus on weight loss. Everyone, no matter their size, could use some professional guidance at times, especially by someone trained in weight-inclusive care. Working with a HAES-aligned dietitian can help you with eating issues to cultivate a more peaceful relationship with food and your body.
In the future, say no to the scale
If you are struggling with an eating disorder or body image issues, being weighed at the doctor is an unnecessary trigger. Ask if you can opt out of the weight check at your next visit. Unless your doctor needs it to monitor weight restoration or maintenance in your recovery (in which case they can do a blind weight), before an operation, to prescribe medication doses or track some threatening illnesses such as kidney failure or congestive heart failure, they don’t need your weight. However, you should tell your doctor if you believe you have experienced any significant changes in your weight as that may be an indication of a health issue that needs attention.
It’s important that your medical professional take into consideration social determinants of health, such as income level, experiences of discrimination, including weight stigma, job security and other factors that might affect your stress levels. Research has shown that food and exercise contribute to a mere ten percent of our health outcomes and all other health behaviors make up an added twenty percent.
Additionally, genetic studies have shown that a particular set of weight-regulating genes is by far the most important factor in determining what a person will weigh. Instead doctors often rely on the BMI, which was created in the 19th century by a Belgian statistician to access the weight of a population of males. It was not created for and was never intended to be used on individuals to assess their health.
Having a doctor tell you to lose weight can bring up intense feelings of fear, shame, and frustration. Many of us are conditioned to believe that thinness equates to health, so taking a doctor’s advice about our weight without question might be our natural response. But your health encompasses more than just your weight, so before you walk away with a vague prescription for weight loss, push for more helpful health advice.
If you are concerned disordered eating behaviors are impacting your health, reach out to us for an initial consultation. Our team of eating disorder clinicians works virtually to treat California residents using a Health At Every Size, weight-inclusive approach.v
