Weight Stigma in Healthcare
Have you ever experienced weight stigma? Unfortunately, many people experience weight stigma on a daily basis, in multiple situations, especially in the healthcare system. Today, Allison Tucker, RD is talking about what happens when your weight is blamed and your medical condition is ignored, and shares tips on how to advocate for yourself. Take it away, Allison!
Weight Stigma in Healthcare
In our practice, we often hear from clients who’ve been dismissed or judged in medical settings because of their weight. Many individuals, especially those in larger bodies, report feeling overlooked when seeking medical care. While a person’s weight may intersect with some health conditions, blaming every issue on it is a huge misstep.
The assumption that weight is the primary—or only—factor in many health conditions stems from longstanding biases that are deeply ingrained in the healthcare system. Studies show that patients in bigger bodies are often viewed as lazy, non-compliant, or even undeserving of care due to assumptions about their lifestyle choices. We know that couldn’t be further from the truth.
How Weight-Centric Care Fails Patients
Let’s consider an example. A patient in a larger body comes to their provider with knee pain. Instead of evaluating the issue thoroughly, the provider suggests weight loss as a remedy. While weight may play a role in joint health, immediately prescribing weight loss without additional investigation fails to address the immediate pain, overlooks potential structural damage, and assumes weight loss is both achievable and necessary for improvement.
Ironically, conditions often linked to body weight, like sleep apnea, are exacerbated by the very factors that this advice might ignore—like stress and poor sleep. Poor sleep can contribute to weight gain, as well as issues like inflammation and metabolic irregularities. Bottom line: advising weight loss without addressing other issues (like sleep quality in this example) can be both ineffective and dismissive.
Why Labeling Weight an “Epidemic” Does More Harm Than Good
Framing ob*sity as an “epidemic” has fueled the stigma, equating body size with disease instead of seeing it as one of many factors in a person’s health. Unfortunately, this widespread weight bias often leads to poorer health outcomes, especially in the long run.
Effects of Weight Stigma – Physical Health
Avoidance of Healthcare due to fear of weight-related judgment, leading to delayed diagnoses and untreated conditions.
Chronic Stress elevates cortisol levels, which can weaken the immune system, disrupt sleep, and worsen metabolic health.
Impact on Health Behaviors: Weight stigma can lead to decreased physical activity due to fears of judgment and shame in fitness environments.
Higher Rates of Health Conditions like diabetes, high cholesterol, high blood pressure, and cardiovascular disease.
Delayed Preventive Care: Many individuals put off scheduling essential preventive measures like cancer screenings and blood pressure checks, increasing risks of advanced health issues.
Effects of Weight Stigma - Mental Health
Increased Anxiety and Depression: Weight-based discrimination is closely linked to higher rates of anxiety, depression, and other mood disorders.
Lower Self-Esteem and Body Image: Constant negative messaging about weight can damage self-esteem and promote body dissatisfaction, leading to mental health challenges.
Social Isolation: People experiencing weight stigma may withdraw from social settings to avoid judgment, leading to loneliness and a lack of social support.
Higher Rates of Disordered Eating: Weight stigma can lead to disordered eating behaviors.
Increased Risk of Suicidal Thoughts: Research shows a correlation between weight discrimination and increased risk of suicidal ideation, highlighting the severe impact on mental well-being.
How to Advocate for Yourself
Weight stigma can make people feel powerless in medical settings. Here are some tools to help:
Ask About Alternatives | When weight is suggested as the primary treatment, try asking, “Are there alternative treatments that don’t involve weight loss?” or “Can we focus on solutions for my symptoms?” This can encourage your provider to consider other approaches.
Bring Support | Having a friend or family member with you can provide extra support, helping you feel confident in redirecting weight-focused conversations.
Look for Weight-Inclusive Providers | Whenever possible, seek providers known for practicing weight-inclusive care. These providers focus on holistic health and respect a patient’s body autonomy, which can create a more positive healthcare experience.
What about Eating Disorder Care?
One study found that eating disorder diagnoses are delayed by an average of 9 months among patients who were once overweight or ob*se compared with patients who were never overweight. Less than 6% of individuals battling an eating disorder are underweight, meaning many people can fall through the cracks, especially people living in larger bodies.
Choosing Empowerment in Healthcare
Focusing exclusively on weight can lead to oversimplified health solutions that overlook important social, economic, and environmental factors. At Collaborative Counseling & Nutrition, we support patient-centered care that values each person’s unique health needs. By spreading awareness, challenging weight-centric advice, and advocating for stigma-free care, we can collectively work toward a more inclusive and effective healthcare system.
Resources Used:
American Psychological Association. (2022). Understanding weight stigma. Monitor on Psychology. Retrieved from https://www.apa.org/monitor/2022/03/news-weight-stigma
Harrison, C. (2019). Anti-diet: Reclaim your time, money, well-being, and happiness through intuitive eating. Little, Brown Spark.
Montgomery, Amanda. Addressing weight stigma and fatphobia in public health. UIC School of Public Health. Retrieved from https://publichealth.uic.edu/community-engagement/collaboratory-for-health-justice/addressing-weight-stigma-and-fatphobia-in-public-health
Pearl, R. L., Wadden, T. A., & Jakicic, J. M. (2021). Is weight stigma associated with physical activity? A systematic review. Obesity, 29(12), 1990–2013. https://doi.org/10.1002/oby.23354
Puhl, R. M., & Heuer, C. A. (2010). Obesity stigma: Important considerations for public health. American Journal of Public Health, 100(6), 1019–1028. https://doi.org/10.2105/AJPH.2009.159491
Tribole, E., & Resch, E. (2020). Intuitive eating: A revolutionary anti-diet approach (4th ed.). St. Martin’s Essentials.
Collaborative Counseling & Nutrition is an outpatient nutrition and body image counseling center, with locations in Indianapolis and Carmel, that provides compassionate, holistic eating disorder treatment. Through practicing mindfulness, intuition, and Health At Every Size, we are on a mission to help you find a true state of well-being! We take an anti-diet, weight-inclusive approach with all our clients and work to help guide you towards a way of healthy living designed by you, just for you! This post is for education purposes only and should not be used as a substitute for treatment for an eating disorder. If you are looking for a registered dietitian or therapist to assist you on your recovery journey, please reach out today!
