HOW TO NAVIGATE WEIGHT STIGMA IN HEALTH AND WELLNESS

Is the focus on weight impacting the quality of health care that’s being provided? Let’s explore how weight stigma plays a role, and the importance of adopting a neutral approach that’s inclusive of all.


BY: EMILY FONNESBECK, RD, CD, CLT

Conventional thought is centered around the thought that body discontent motivates someone toward healthy behaviors. However, mounting evidence and clinical practice finds the opposite – body discontent is associated with disordered eating patterns, binge eating, lower levels of physical activity and increased weight gain over time. Despite differing opinions, this has led to increased traction and attention around weight bias and weight stigma amongst nutrition and health professionals.

But let’s shift the focus back on to the patients themselves. What’s going on in their minds?

Because of their own internalized weight stigma, patients may feel they deserve to be labeled as “overweight” or “obese”, and need to be told to lose weight. They likely don’t realize they are being stigmatized or shamed, or they may not be aware how that stigma further encourages body dissatisfaction and disordered eating patterns.

For these reasons, plus the accompanying delayed healthcare, weight cycling, increased psychological and emotional stress, weight stigma is actually worse for someone’s health than the weight itself. If we are truly concerned with the health of an individual, we will treat them as a whole person rather than just focusing on and treating their weight.

In fact, harmful health consequences can happen when clinicians are blinded by weight bias.

Stigmatization happens when we pathologize weight or body size, encourage the fear of fat or dehumanize an individual based on their size. You may be surprised to find that encouraging weight loss or labeling someone “overweight” or “obese” is, in fact, weight stigma.

Instead, what if we consider engaging in conversations about weight and size through the terms    “weight concerns”, “higher weight” or “fat”? These types of terms are weight-neutral in terms of describing body size. Just as we may describe someone as “thin”, we can also describe someone as “fat”, without the “good” or “bad” connotation of the word.

So what happens when we place value on weight loss?

It causes widespread anxiety about weight for everybody of every size. It’s hard to see weight loss as positive goal for anyone when we recognize that no method has been proven to reduce weight long term for a significant amount of people.

Weight cycling is the actual outcome, which has been linked to higher risk of inflammation, hypertension, insulin resistance, and dyslipidemia. It also increases the individual’s set point, or the genetically predetermined weight range where the body functions most optimally. You’d be hard pressed to find any situation which warrants placing value on weight loss. Even if the goal is to manage a health condition, many nutrition interventions can change metabolic profiles within days (blood sugar for example), before any significant weight loss.

We can treat the condition, not the weight.

Patients are constantly experiencing weight bias and weight stigma in society; from the workplace, to their doctor’s offices, and even in their own homes. By assessing our own weight bias and avoiding stigmatizing language, we can help others feel seen, valued and heard in ways they maybe haven’t felt before. We can start promoting an environment conducive for everyone to have a healthier relationship with food and their body image.

After all, a healthy weight will not be one found through restriction, extremes, manipulation and/or preoccupation. Instead, let’s adopt a weight-inclusive approach which gives access to non-stigmatizing health care, so we can all maintain a healthy body. 

Because we all deserve to achieve a state of well-being, regardless of our size.

Adapted from the original article.
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Emily Fonnesbeck, RD, CD, CLT is a private practice Registered Dietitian based in Saint George, Utah. Instead of creating unnecessary restrictions, Emily focuses on helping individuals become confident and in charge of their own well-being through Intuitive Eating and Mindful Living. She is a strong believer and advocate for helping people become capable individuals who are confident in taking care of themselves.  Make a visit and read more from Emily.

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