Dismantling Weight Bias
By Amber Charles, MSPH, RDN
February 2, 2021
Losing weight is not the cure for an incurable disease. Appropriate medical and nutritional interventions need to be the focus of healthcare.
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Weight Bias: What is it?
Lisa is "obese" with type 2 diabetes.
Mary has a "normal weight", but also has type 2 diabetes.
Lisa is told to lose weight to manage her diabetes while Mary is given medical interventions specific to diabetes management.
That, in a nutshell, is #weightbias (in healthcare).
It is the stereotyping and discrimination against those persons in 'larger bodies', simply based on their weight alone.
It is the negative attitude and beliefs about persons who are overweight or obese.
In a weight-focused healthcare system, this poses several challenges.
Weight Bias: The Dangers
Large or small body, you can have high cholesterol.
Large or small body, you can suffer from a chronic condition.
The point is that weight bias robs some individuals of the opportunity to learn and self-manage their health. Instead of treating the medical condition itself, weight loss becomes the focus.
In turn, weight bias perpetuates disordered eating patterns, such as binge eating or food avoidance to engage in unhealthy weight control practices (#faddiets).
Not only is it an issue of social inequity, it also is a low-blow that can trigger depression, anxiety, low self-esteem, poor body image and suicidal acts & thoughts.
The fallacy that losing weight is the solution to happiness and ultimate health is the work of #dietculture (read more here).
Health at Every Size (HAES®)
According to the Association for Size Diversity and Health (ASDH):
"The Health At Every Size® (HAES®) approach is a continuously evolving alternative to the weight-centered approach to treating clients and patients of all sizes. It is also a movement working to promote size-acceptance, to end weight discrimination, and to lesson the cultural obsession with weight loss and thinness".
Regardless of your weight, you have a right to the appropriate medical and nutritional care.
Read why the BMI scale is not a direct indicator of health.
What you can do
1. Evaluate your own biases
Assess yourself: Take the Harvard Implicit Association Test (IAT) to get started.
Understand that age, race, economic status and other factors impact weight stigma. Try to create a supportive environment that address these inequities.
2. Just. Stop. Commenting.
Shaming someone for their body weight does not motivate positive behaviour change.
Furthermore, commenting on someone's weight gain (or even weight loss) maintains the stereotypes.
3. Focus on the health issue first
Since we've established that weight loss will not magically cure your medical condition, a patient-centered approach needs to be the priority.
Treat the condition, weight loss can be the side effect.
Disclaimer
I am an advocate for, "your body, your choice". You may choose to pursue weight loss for various reasons. My appeal is to do so without obsession, fad dieting and with the understanding that weight loss is not a cure-all, ultimate happiness destination.
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