Fat-shaming at the doctors hurts patients long-term. Here’s how to choose a “weight-neutral” doctor:

For the past few years, more and more people have been joining the body positivity movement—which is rooted in the belief that all human beings should have a positive body image. On the other hand, the fat acceptance movement, a predecessor of body positivity, is a social movement seeking to change weight bias and stigma. While both of these movements are leading the way to make a change in our society, certified intuitive eating coach Krista Murias explains on her recent Instagram post, “It’s about acknowledging the harm that fatphobia causes and calling it out, and actively working to change it.” And this includes the health care system. 

In 2015, Obesity Reviews published a peer-reviewed journal article about how weight bias and stigma reduces the quality of health care that overweight people receive and can influence a healthcare provider’s decision making. Still, very few people are comfortable accepting fat and even fewer are reclaiming the F word that plagues people who are plus-size and marginalized by society. Your Fat Friend, though, an anonymous self-identified fat queer white cis lady with close to 90k Instagram followers, is looking to change that. 

In a recent post, she expressed how difficult it is for fat people to find health care providers that don’t mention their weight and treat them like straight-size people. “Too often, fat folks struggle to find health care providers who can even offer us basic, competent health care. And since it’s open enrollment time for many of us in the U.S., what better time to share provider experiences?” she said. Responses poured in from people around the world with their suggestions of highly recommended fat-friendly health care providers. One commenter mentioned a group on Facebook called Boise Rad Fat Collective that has an ongoing list of weight neutral/health-at-every-size providers aka HAES. (HAES is a movement to treat clients and patients of all sizes without weight bias). 

Another commenter chimed in about Dr. Kelvin Ma, DO, who is from Colton, California. “He never comments on my weight or blames my medical issues on weight. When I came to him for my depression, he prescribed me a med that I knew would cause weight gain. When I asked him about the weight gain and if it was ‘bad’ he looked at me and said, ‘That doesn’t matter. Your well-being and happiness is what matters,’” she wrote. 

One of the main reasons why people are biased towards fat people is because they assume all fat is unhealthy.

But someone that is categorized as overweight or obese can be considered healthy. The National Institutes of Health defines an overweight person with a BMI (the mass body index) of 27.3 % or more for women, and 27.8% or more for men, whereas obesity is a BMI of 30 and above. 

However, according to Mcgill Office For Science and Society, while people with obesity may be healthy today, they may not be healthy tomorrow. In a 2017 study published in the Journal of the American College of Cardiology, researchers tested obese individuals free of diabetes, high blood pressure, and high cholesterol and found that they were still at risk of heart disease long-term.

Health care providers who practice with a HAES/fat-friendly mindset, keep these truths in mind when treating their patients, but they also don’t base their treatment or care on their patient’s size. “HAES providers acknowledge the research showing that the pursuit of weight loss is ineffective and actively harmful, because it creates weight cycling and perpetuates weight stigma, both of which are independently harmful to health,” intuitive eating and anti-diet dietitian Christy Harrison, who just published ANTI-DIET, tells HelloGiggles.

“In fact, weight stigma and weight cycling likely explain most of the excess health risks associated with being in a larger body. HAES helps people avoid these risks and take care of themselves through evidence-based interventions, which do not include weight loss, she concludes.

As a HAES provider, Harrison helps her patients heal from the weight stigma and disordered eating caused by our fatphobic and food-phobic culture (aka diet culture). 

Rebecca Scritchfield RDN, the author of Body Kindness, a weight-inclusive approach that rejects diets as a form of health improvement, has a similar approach.

“While many people who see me have weight concerns, and I am sure to hold space for their concerns and their relationship to their body, I do not center weight loss as the valuable outcome of our work together, Scritchfield says. “This is a crucial aspect of a HAES informed counseling practice because of the known harms of weight bias. Additionally, committing to social justice awareness and education is essential for HAES informed practice. Acknowledging my privileges with clients and other helping professionals is one of the simplest ways of practicing social justice awareness, she adds.

With close to 250k Instagram followers, Dr Joshua Wolrich MBBS, MRCS, a national health service surgical doctor who is fighting weight stigma and nutribollocks (spurious nutrition advice with little to no scientific evidence, which is frequently used on social media to make a profit and promotes disordered eating), is one of the few men in the healthcare industry addressing weight stigma and diet culture.

As a fat-friendly health care provider, he debunks widespread health claims like explaining to his readers how carbs don’t make you fat and weight loss goals aren’t risk-free.

“My job as a doctor is to try and improve the health of my patients. But if I indiscriminately prescribe weight loss without an understanding of the nuances and potential harm my advice can have, I’m not doing my job properly,” he wrote for Healthline. These risks that come from prescribing weight loss include disordered eating, increased blood pressure, and depression, he explained. 

“Unfortunately, for many fat patients, the doctor’s office can be the source of even more stigma—rather than a safe haven where we can focus on our health,” Your Fat Friend tells HelloGiggles. “I’ll never forget having my blood pressure taken four times in a row. When I asked why she had taken my blood pressure so many times, the tech told me the cuff must not be working, because my blood pressure was in a healthy range. She couldn’t believe that a fat woman could have healthy blood pressure. It made me feel so alone and so judged.”

Evidently, because of diet and culture, YFF is far from alone in her struggle to find a healthcare provider that doesn’t mention her weight. If you take a glance at her page, you’ll find many more stories from her followers like the one she shared about being discriminated against based on her size. That’s why it’s so important for health care providers to treat all their patients equally. They should take a cue from these fat-friendly trailblazers and acknowledge that the dangers of weight stigma can be far worse than fat itself.