Weight Bias in the Medical Profession

What if you broke your arm and you went to the emergency department, but instead of being told you needed to get an x-ray, the doctor told you that you "should really lose some weight".  Somehow suggesting that this accident wouldn't have happened if you weren't overweight.  Or that you felt something didn't feel quite right in your body, instead of being sent for bloodwork or other investigations, you were told that the symptoms you were experiencing were from being obese.  In addition to this, you're obviously eating McDonald's all day, and "have you considered Weight Watcher's, or what's the new diet again, Keto?  Maybe you're eating too many carbs."  What if you did go to see a dietitian and they had a look of disapproval before you even stepped into their office. Recently, a Newfoundland woman wrote in her own obituary about her experience of trying to seek medical help for her terminal cancer and yet only got suggestions to lose weight.

Her obituary explains her final message that:

"Ellen wanted to share (..) about the fat shaming she endured from the medical profession. Over the past few years of feeling unwell she sought out medical intervention and no one offered any support or suggestions beyond weight loss. Ellen's dying wish was that women of size make her death matter by advocating strongly for their health and not accepting that fat is the only relevant health issue."

As shocking as it may be to hear that someone was dying, and they got no other help than a suggestion to lose weight, it's a sad, common occurrence.  The weight-related bias of health professionals has been well documented in research.  A study published in 2003 showed that many health professionals (doctors, nurses, dietitians, physiotherapists, etc., etc), including those that state that they work in the area of weight management have a strong weight bias for thinness.

The implications of this bias is not only shown with Ellen's story of health professionals missing early signs of more ominous health concerns.  But those that are overweight are also less likely to seek medical help, knowing that they will be discriminated against at every turn.  Even worse, this weight stigma is then internalized by the patient.  Internalized weight-stigma has been associated with increased binge eating, lower levels of physical activity, elevated cardio-metabolic risk and poorer health-related quality of life.   So by shaming patients about weight, they are getting sicker and sicker.

Is there another way?

With the advent of movements such as "Health at Every Size" (HAES), slowly but surely, there are some health professionals that are trying to move away from using weight as the only, and most important, measure of health.  HAES is based on the extensive body of research that shows that this constant weight loss "battle" is not improving health outcomes, but is only a billion dollar industry of life-long consumers.  Health is not measured in pounds but by how we treat our body.  That healthy bodies are strong and they are fed the food it needs (not just what is deemed a "super food").  These bodies are moved around to keep the blood flowing, muscles moving and heart pumping.

My body may be different than your's, and your body may be different than their's.  Everyone's body is enough.  Everyone knows their body best.  Every body should be treated with dignity.

-jb