How To Find a Weight-Inclusive Healthcare Provider

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A doctor’s office is supposed to be a safe place where you’re treated with respect. But if you’re in a larger body, that can sometimes be far from your reality due to weight stigma, or being treated with negative attitudes, prejudice, and discrimination due to your body size. “Weight stigma in the doctor’s office is fueled through the weight-centered approach we have in our country in general—society idolizes being thin and it’s seeped into our healthcare system,” says Lauren Butler, PhD, RDN, an assistant professor of nutrition at Texas State University.

This isn’t all the fault of healthcare providers: Putting an emphasis on weight is taught in medical schools. “As providers, if we follow all the guidelines about treating body size as a disease and attributing symptoms and disease solely to body size, we’re spending all of our precious time with patients talking about weight and offering ideas like diets and medications that don’t work,” says Lisa Erlanger, MD, clinical professor of family medicine at University of Washington School of Medicine. “They don’t work to make people smaller, and they don’t work to change the course of diseases long-term.”

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Being treated this way can be incredibly harmful. “It’s associated with depression and anxiety, binge eating, poor body image, substance abuse, and exercise avoidance,” says Butler. The stigma can also bring on more health issues. “We have been blaming the body and the people in those bodies for the health problems when weight stigma and the weight cycling that results from it better accounts for all the extra health problems people in larger bodies have,” says Erlanger. One reason why is that discrimination can lead to chronic stress and internalized shame. “This has a direct metabolic and physiological effect on the body that causes the diseases often blamed on the fat body itself,” says Erlanger.

Making matters worse: Weight stigma can cause people to stop going to the doctor. “They lose trust in the healthcare system or are too embarrassed to return after an encounter that felt humiliating because of its focus on weight,” says Erlanger. That’s why it’s so important to make sure you have a weight-inclusive medical provider—one who is focused on your overall well-being, not just your weight.

Red Flags to Watch Out For

Are the chairs all small, are there magazines set out that talk about weight loss, or do you see ads for aesthetic treatments?

There are some obvious ways to tell that your doctor has bias, like if they are focused on your weight in every visit. “Some physicians might launch into a discussion of weight regardless of the reason someone is there,” says Erlanger. “So patients experience this as not being listened to.” Other clues pop up with how your doctor talks to you. Do they avoid eye contact, rush through the appointment, or imply you are non-compliant and to blame for your health issues? Also consider how you’re treated when you’re getting weighed: Is it in a public place? Are comments made afterwards that make you feel bad?

There are also some more subtle signs as well. Take the waiting room, for example. Are the chairs all small, are there magazines set out that talk about weight loss, or do you see ads for aesthetic treatments? And in the exam room, there may not be the right gear for people with larger bodies, such as larger blood pressure cuffs and exam gowns. These are all red flags that may tell you it’s time to seek care elsewhere.

Identifying Weight-Inclusive Providers

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It’s a myth that weight-neutral doctors never talk about weight, food choices, or exercise. “We aren’t saying weight isn’t a part of providing healthcare, but there is a way to talk about weight that decreases stigma,” says Butler. This means a doctor will ask you if you’re okay discussing your weight or even knowing what it is. It also means encouraging healthy behaviors like eating more fruits and vegetables and incorporating movement into your day, but not because it will help you lose weight, but because they’re good for your overall health. There is also a lovely acceptance you’ll feel from a weight-inclusive healthcare provider. “The foundation of weight-inclusive healthcare is an acknowledgement that bodies naturally come in a range of sizes, that weight and BMI is not a useful measure of health, and that it’s also not a useful or appropriate target for medical intervention,” says Erlanger. “They respond to patients’ actual concerns without blaming body size.”

In a perfect world it would be easy to find a weight-inclusive healthcare provider, but it can be a little hard—especially if you don’t live in a larger city. Here are some places to look.

  • Directories: Some organizations have searchable databases of providers who are weight neutral. The Association for Size Diversity and Health has one searchable by keyword. HAES, which stands for Health At Every Size, has a collection of resources on their website, including a list of Fat-Friendly Health Professionals. And Bare Health is another online directory searchable by state.
  • Word-of-Mouth: You aren’t the only one who wants to see a weight-neutral provider, so ask around with friends, family, or online communities that share similar values. “There are weight-inclusive physicians all over the country and asking friends or finding fat communities on social media is a way to get names,” says Erlanger. Bonus: You’ll get to hear first-hand what a provider is really like before you even make your first appointment.
  • Internet search: This sounds basic, but it works. Type “weight inclusive dietitian” or “weight neutral rheumatologist” into a search engine and see what comes up.

Evaluating Potential Providers

So you think you’ve found a good weight neutral provider, but want to know for sure? Here are some steps to take:

  • Look at their website and read online reviews. There’s a lot of good info you can find online—from reviews of other patients to details on their approach to weight and health. Do they talk about how they approach weight loss or obesity treatment? “Look for words like person-centered, inclusive care, or a focus on diversity and equity,” says Butler. “Usually those types of providers are going to have compassionate care that’s non-stigmatizing.”
  • Have an initial phone conversation. “I encourage people to call and say that you’re interested in a provider who can give me weight-neutral or weight-inclusive care and is there someone on staff who would be able to do that,” says Butler. “It’s harder to bring up things like not getting your weight checked when you’re face to face, so a phone call is a way to understand what you’re going to be walking into.”
  • Pay attention during your first appointment. You’ll be able to tell how much importance they put on weight pretty quickly. “The big thing is that they talk about your weight no matter the issue. So you have knee pain and the doctor starts right off with losing weight,” says Butler. “That shows you aren’t getting the care you need and that someone in a thinner body would get with the same concern.” Also check things like if the chairs in the waiting room are sized for people with larger bodies and are there right-sized gowns and equipment.

The Bottom Line

If you have found a good provider, make sure that you continue to work on having a positive relationship—one that suits you for a long time to come. Openly discuss any concerns you may have about weight stigma if you feel it creeping in. “I think the best thing is to be direct,” says Erlanger. “Something you can consider saying is: ‘I don’t want my weight to be the focus of our healthcare or a measure of the effectiveness of our healthcare. Are you willing to set that completely aside and treat me the same in all ways as someone in a smaller body?’”

It may feel awkward at time to have these kinds of conversations, but remember: All you are doing is asking for the care you deserve.

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