What does weight-inclusive health care mean? A dietitian explains what some providers are doing to end weight stigma

Weight-inclusive healthcare means that the focus is on better overall health without any weight loss requirement.

It includes eating for your overall health and not just for calories. This may consist of prioritizing stress-reducing activities, quitting smoking, drinking less, and finding enjoyable ways to be physically active.

Weight-inclusive health care aims to eliminate the stigma associated with weight.

People with larger bodies often experience weight stigma. This can include discrimination, stereotypes, and negative judgments, even from their doctors and other healthcare providers. Over 40% of U.S. adult women and men of all sizes say they experience weight stigma every day.

The desire to avoid this stigma may have a large part in why Americans go to such great lengths to lose weight. According to market data, Americans will spend approximately US$72.6 Billion in 2021 on weight loss programs and products. Weight loss efforts begin early. Nearly half of the high school students report that they tried to lose weight.

I am a nutrition etiologist and registered dietitian. My research focuses on the effects of weight stigma.

My private practice and my research were initially weight-centered. Weight-centered approaches are widely used in healthcare settings around the world. They focus on weight loss as a means to improve health. In my work as a public health nutritionist, I’ve seen how the weight-centered method harms both individuals and communities. In my research and practice, I now use an approach that includes weight.

The ‘lower body weight = better health’ myth is a myth

There are many research studies and health messages that show an increase in body weight is linked to long-term health issues such as high blood sugar and Type 2 Diabetes.

There is a widespread misconception that weight-inclusive care ignores patient concerns. Weight-inclusive advocates argue that this approach reduces health issues by de-stigmatizing obesity and promoting equity. The researchers also admit that there is a link between higher or lower body weight and various health issues.

Researchers and healthcare providers are questioning the dogma that lower body weight equals better health. Scientists and clinicians call for a shift from the weight-centered emphasis on body mass index and weight status as indicators of health.

Advocate groups such as the Association for Size Diversity and Health promote the Health At Every Size strategy. This weight-inclusive method affirms a socially fair definition of health and advocates for equal health care, regardless of weight. The American Medical Association has released a recent statement that outlines the harms of using BMI to measure health.

Weight stigma can cause chronic stress, depression, and social isolation. It also lowers self-esteem.

Weight-inclusive Care: The Evidence

Research shows that it can support long-term health regardless of weight. A systematic review of 152 peer-reviewed observational studies and one clinical trial found that a high-nutrient diet combined with moderate or low alcohol consumption was associated with a reduced risk of mortality for all.

Another example: A client of mine with high cholesterol told me that, throughout their lives, focusing on weight loss had led to disordered eating habits, extreme and inconsistent exercise, and concerns about body image. Instead of focusing solely on weight loss, they adopted weight-inclusive practices, such as increasing fiber intake and physical activity, which led to a return to normal cholesterol levels.

Weight-inclusive and weight-centered approaches can both include diet changes, increased physical activity, and stress reduction as key components in managing and preventing diseases. Weight-inclusive methods work to eliminate weight stigma and recognize that factors like socioeconomic status and accessibility to food and healthcare, collectively known as the Social Determinants of Health, have a huge impact on a person’s body size, shape, and weight. The individual cannot control structural and political factors that affect health and weight.

Fails to maintain the pounds they lose.

Finding weight-inclusive health care

People can look out for several things in a practice that includes weight as part of their health care.

Find health care providers that:

  • Weight checks can be optional at routine visits.
  • Instead of telling patients to lose weight, treat their symptoms.
  • Patients with larger bodies should receive the same care as patients with thinner bodies who have similar health concerns.
  • Diagnose health issues using measures other than BMI.
  • Before discussing weight with a patient, ask for their permission.

Check out the Health At Every Size Health Sheets for additional resources. Take an online test that focuses on implicit association around weight to examine your own bias.

It is important to examine the details of today’s National Cabinet Decision. There are two things to watch out for.

Will the cap of 6.5% be raised? How much will it increase? The total amount that the Commonwealth may be required to pay the states is determined by this.

What will the states agree to as a result of any potential increase in Commonwealth spending? A commitment to share expenditure on NDIS reform (and work together) may be in the cards.

The funding commitments made for “reform” projects send a signal about the issues that governments believe are most important in the public health system. For example, joint obligations can be made to increase efficiency or expand access to digital services such as telehealth.

Patients could benefit from an improved public hospital system if the Commonwealth shares and the cap are increased, as long as they are coupled with tighter accountability (such as a commitment to reduce waiting times for planned procedures).


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