It's no secret that weight stigma in healthcare is rampant. From doctor’s visits where they’re more concerned with your weight than your wellbeing to health coaches that are trying to stuff the next diet down your throat, weight loss is often seen as the cure for all ills.
At least that’s what I’ve been told time and time again by other health professionals. Like the time I was told by my physician that even though I looked fit I could stand to eat more salads - keep in mind she NEVER asked me what I ate. Or, the time another physician spent half my examination telling me that I should avoid snacking - while never telling me why.
Despite evidence to the contrary, there are still health professionals who believe a person's weight determines their health status.  What I know from the research as well as my own personal experience is that this cannot be further from the truth. Weight stigma, and specifically anti-fat bias, is a threat to our wellbeing and it's time that we do something about it.
That’s why in this article I share why anti-fat bias Is a threat to the health of your patients and clients and what you can do about it!
What is Anti-Fat Bias?
Anti-fat prejudice or bias is defined as a tendency to form judgments about people solely based on their body weight.  Research has shown that due to negative stereotypes about fat people, physicians may not thoroughly examine patients or reflect on their health conditions. 
Beyond the obvious ethical issues, anti-fat bias is a barrier that can prevent your patients and clients from receiving quality care. What we know from the literature is that anti-fat bias can decrease the likelihood that your patients and clients will seek preventative care, which increases the likelihood of disease and higher healthcare costs. 
When we, as health professionals are engaged in anti-fat bias, we are preventing our patients and clients from getting the care they need. As a patient and client myself, I know firsthand the serious impact that anti-fat bias can have on your overall health and wellbeing.
How Anti-Fat Bias Has Impacted My Health
As someone who benefitted for many years from thin privilege, I didn’t understand the impact that anti-fat bias has on your health until I developed an autoimmune condition. I first became aware of my condition in 2012 while I was serving in the Marine Corps. But, it wasn’t until 2019 when I was diagnosed with rheumatoid arthritis and Sjögren's syndrome that I would begin to fully understand the impact of anti-fat bias.
Prior to that diagnosis, I did what I thought I was supposed to do:
- I calculated my macros and counted every single calorie I ate.
- I strength trained 3-5 days a week and did cardio 5-7 days a week.
- I maintained what I thought was a healthy weight.
Despite all these healthy habits I was engaged in I started struggling with food sensitivities. So, I cut out dairy and gluten. Then, I started struggling with unexplained weight gain. So, I began intermittent fasting. Even when I went to my physician about my health concerns their only recommendations were to avoid the foods I was developing sensitivities to and of course, lose weight.
No matter what food I avoided or how many pounds I lost, neither kept me from developing two autoimmune diseases. While I’ve found an amazing care team to support me in managing my autoimmune condition, there is a part of me that wonders how different my life would be if my physician had been concerned with my wellbeing, not just my weight?
Although weight management is a central component of healthcare regimens evidence demonstrates that the focus on weight loss has created unintended harm.  For this reason, I truly believe that improving the health of our patients and clients requires a weight-inclusive approach.
What’s a Weight-Inclusive Approach to Health?
A weight-inclusive approach rests on the assumption that everybody is capable of achieving health independent of their weight.  This means as health professionals we have a unique opportunity to help our patients and clients unlearn the harmful practices that contribute to ill health. Whether that is following overly restrictive diets or spending ungodly hours in the gym, there are common habits we might think are healthy that do far more harm than they do good.
Research has shown that a weight-inclusive approach fosters better health by prioritizing wellbeing over weight loss.  Further, from what we know from the literature unhealthy dieting practices, sedentary behavior, and weight gain is reduced when individuals are free from anti-fat bias. 
Although you’ve likely been taught the opposite we must stop blaming the individual and start holding the system accountable for the adverse health of our patients and clients. It’s our responsibility as health professionals to support our patients and clients, by ensuring that anti-fat bias is not a barrier to their wellbeing and quality of life.
What Health Professionals Can Do to Combat Anti-Fat Bias
You might be wondering what can YOU do as a health professional to combat anti-fat bias in your clinic or practice? For one, you can educate yourself on the latest research regarding the health impacts of anti-fat bias. It wasn’t until I became aware of anti-fat bias and how it negatively impacts our health that I became committed to fighting it.
Even if you think you’re the most open-minded individual in the world, it’s a good chance that your clinic or practice is not as weight-inclusive as you think it is. That’s why we have to do our due diligence in educating ourselves on the latest research from places like PubMed or the National Association for the Advancement of Fat Acceptance. Because we can’t do better if we don’t know better.
Secondly, you can enlighten your patients and clients on the importance of a weight-inclusive approach to their health. Once I started working with health coaches and practitioners who challenged my anti-fat bias I was able to start seeing health through a very different lens. Just as you’ve educated yourself about anti-fat bias and weight-inclusivity, it’s time that you do the same for your patients and clients.
Don’t worry, you don’t need to be the actual teacher. Instead, you can recommend podcasts like Listen to Your Body by Steph Gaudreau or Instagram accounts to follow like Running Fat Chef. The point is to provide your patients and clients with opportunities to read, listen or see that they can in fact achieve health at every size.
Lastly, you can encourage your patients and clients to set non-scale health goals. As someone who used to weigh in every Sunday, I understand that the scale is a common way for people to measure “progress.” The problem with using weight loss as a measure of progress is that when your patients and clients aren’t losing weight they may falsely believe they’re not making progress.
Therefore, shifting toward non-scale health goals allows your patients and clients to expand their view of health beyond the scale. That might mean setting a goal to make 3 home-cooked meals each week or training for their first 5k. Regardless of what goal they set it’s imperative that you help them set a health goal that has nothing to do with their weight. When you do, you’re going to be able to create a more inclusive clinic or practice for everybody.
So, What’s Next?
As you can see, anti-fat bias is a serious issue. It's not just about self-esteem and body image; it has real consequences for health as well. Much of what we know to be true is that you can achieve health irrespective of your weight, which is why combating anti-fat bias is imperative for improving the health and wellbeing of our patients and clients.
I hope this article has provided you with some new ideas on how to combat anti-fat bias by using a weight-inclusive approach that is grounded in facts rather than anecdotal information found on the internet.
Now that you’re armed with some tips, which of these will you implement first? Let me know below!
1. McHugh, M.C. & Kasardo, A.E. (2011). Anti-fat prejudice: The role of psychology in explication, education, and eradication. Sex Roles, 66, 617-627. http://dx.doi.org/10.1007/s11199-011-0099-x
2. Schwartz, M.B., Chambliss, H.O., Brownell, K.D., Blair, S.N. & Billington, C. (2003). Weight bias among health professionals specializing in obesity. Obesity Research, 11(9): 1033-1039. https://doi.org/10.1038/oby.2003.142
3. Tylka, T.L., Annunziato, R.A., Burgard, D., Daníelsdóttir, S., Shuman, E., Davis, C., & Calogero, R.M. (2014). The weight-inclusive versus weight-normative approach to health: Evaluating the evidence for prioritizing well-being over weight loss. Journal of Obesity, 2014, 1-18. http://dx.doi.org/10.1155/2014/983495
4. Tomiyama, A.J., Carr, D., Granberg, E.M., Major, B., Robinson, E., Sutin, A.R. & Brewis, A. (2018). How and why weight stigma drives the obesity ‘epidemic’ and harms health. BMC Medicine, 16(123). https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-018-1116-5
Get resources, tips, and more delivered to your inbox. Plus, get instant access to my free training, “Creating a Weight-Inclusive Clinic and Practice for Everybody.”
We hate SPAM. We will never sell your information, for any reason.