Healthy Habits

Weight-Inclusive Healthcare

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Content provided by the GBS Health & Wellness Team

Ask the Expert
With Becca Rick, MS, RD

Topic: Where does weight bias and stigma show up in healthcare, and what actions can someone take to support a shift toward weight-inclusive care?

What is weight-inclusive care?

Before jumping in to why you should care about weigh-inclusive care and what you can do moving forward, let’s start with a couple of definitions.

Weight bias: the negative attitudes, beliefs, judgments, stereotypes, and discriminatory acts aimed at individuals simply because of their weight.1

Weight stigma: the social rejection and devaluation that accrue to those who do not comply with prevailing social norms of adequate body weight and shape.2

I like to explain weight bias as any other form of bias, where judgment and beliefs about someone exist based on a specific characteristic, such as weight status in this context. Bias can take two main forms – implicit, which is unknown; and explicit, which is known.

Weight stigma, on the other hand, can be thought of as a result of weight bias and is more action-driven, such as discriminatory policies or norms that evolve from weight bias.

Why does it matter?

A significant and growing amount of research on the effects of weight stigma show an alarming negative impact on health. One particularly impactful outcome is that weight stigma impacts access to and avoidance of healthcare. According to a review in the Archives of Family Medicine, patients in larger bodies are less likely to complete preventive healthcare exams such as cancer screenings, pelvic exams, and mammograms, and are more likely to delay and/or cancel healthcare appointments. We know delayed care leads to later diagnosis, intervention, and ultimately poorer health outcomes.3-5

Weight stigma is also associated with elevated blood pressure, negative body image, low self-esteem, depression, increased risk of mood disorder, anxiety disorder, and eating disorder. Weight stigma predicts oxidative stress, systemic inflammation, and cortisol secretion.3-5

Given the serious health consequences of experienced weight stigma, the high prevalence also poses concern. One study surveyed 1,300 U.S. participants, of which 42% indicated having experienced weight stigma. Another international study of 14,000 participants enrolled in WW International (formerly Weight Watchers) showed up to 61% of participants reporting weight stigma.6

What can I do?

  • Reframe your understanding of health by untying the connection of weight and health, and instead focusing on behaviors that are known to support health at any weight. Shifting focus toward behaviors like getting adequate sleep, eating more fruits and vegetables, finding ways to move your body, and prioritizing relationships and community support overwhelmingly benefit health status.
  • Assess your weight bias, and work to unlearn it. You can start by taking an assessment through Project Implicit. This site provides a list of IAT tests related to varying biases like religion, gender, race, age, weight, and more.
  • Check out these Don’t Weigh Me Cards to help facilitate more productive visits with your healthcare providers.

Bonus: Interested in learning more on these topics? A few favorite books include:

  • The Body is Not An Apology, by Sonya Taylor
  • The Obesity Paradox, by Carl Lavie
  • Anti-Diet, by Christy Harrison
  • Body Kindness, by Rebecca Scritchfield
  • Intuitive Eating 4th Edition, by Tribole & Resch
  • Intuitive Eating Workbook, by Tribole & Resch

 

References:

1The Obesity Action Coalition, 2021.
2BMC Medicine, 2018.
3Clinical Diabetes | Eating Behaviors, Vol. 9 No. 2 | National Eating Disorders Association
4The Weight-Inclusive versus Weight-Normative Approach to Health: Evaluating the Evidence for Prioritizing Well-Being over Weight Loss, Tylka et al., Journal of Obesity, Vol. 2014, Article ID 983495
5Evidence-Based Rationale for Adopting Weight-Inclusive Health Policy, Social Issues and Policy Review, Vol 14, No 1, 2020
6Lee, K.M., Hunger, J.M. & Tomiyama, A.J. Weight stigma and health behaviors: evidence from the Eating in America Study. Int J Obes 45, 1499–1509 (2021). https://doi.org/10.1038/s41366-021-00814-5

 

 

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