Championing Weight Inclusivity in Health Care

Championing Weight Inclusivity in Healthcare

For many of us, a trip to the doctor can be an anxiety-inducing experience.
 
Sometimes uncertainty takes over and you can find yourself overwhelmed with an array of potential scenarios. Will they be understanding? Will I get the right diagnosis? What if I’m really sick?
 
But when you’re a person living in a bigger body, a doctor’s appointment can be a  completely different ballgame. Couple those uncertainties with weight based stigma and discrimination, and things can get far more difficult.
 
At the age of nineteen, I started feeling really unwell. I begrudgingly took myself off to my family GP and told him about my ongoing stomach problems. He listened to me patiently and suggested we run some tests. I remember feeling listened to and cared for. I should point out that at the time, I was what would have been considered “very slim”.
 
Not once was my weight spoken about or referred to. It turned out that I had coeliac disease and although I was sad to have developed such an inconvenient ailment, I felt thankful for the prompt and high quality medical care I had received.
 
A few months ago, almost 8 years later, my tummy troubles returned. I was referred to a gastroenterologist, and went to the appointment feeling optimistic.
 
Again, I should mention, that due to long-term use of antidepressants and a second diagnosis of Polycystic Ovaries Syndrome (​PCOS​), I was now almost 30 kilos heavier and nowhere near as slim.
 
I explained to the doctor what was going on, how tired I was and that I had a feeling something else was going on with my gut. I’d only been speaking for a few minutes when he delivered his recommendation.
 
“You’re overweight — clearly. I think what you need is just to get out there and get exercising. Get moving. You just have to get into a routine. You know, exercise has been proven to be just as effective as taking antidepressants. I know you say you’re tired but you just have to try a little harder”.
 
His words hit me hard and fast. I left the appointment feeling dejected, embarrassed and really angry. I found myself thinking about people in bigger bodies than mine.
 
What was a doctor’s appointment like for them? How many people out there were experiencing lacklustre health care based on what they looked like or what they weighed?
 
It was around this time that I came to discover the concept of weight-inclusivity and the potential for its application within health care settings.
 
Many health providers are now beginning to adopt a ​‘weight-inclusive’​ or ‘weight neutral’ approach to their practice. This means shifting the focus to healthy behaviours instead of encouraging patients to simply lose weight.
 
 
According to one website, ‘health exists on a continuum that varies with time and circumstance for each individual’. In other words, my definition of health can look completely different to the person sitting on the train next to me. And more importantly, that definition will change and evolve many times within our own lifetimes.
 
Weight inclusivity is a simple, yet apparently radical concept; accepting that bodies come in all different shapes and sizes and rejecting the idea of a healthy weight.
 
When we associate health with a particular body type or weight, not only do we make potentially harmful assumptions about people’s health based on a number, but we effectively exclude people from health care settings.
 
According to a paper published earlier this year titled ​‘An Evidence-Based Rationale for Adopting Weight-Inclusive Health Policy’​, it is clear that ‘there is strong evidence that not all heavier individuals experience poor health, and thus policy should not treat all heavier individuals as though they do’.
 
If we move away from this narrative of “slim equals healthy”, and stop policing larger bodies, we can focus on health outcomes in a holistic sense and ensure inclusivity regardless of size.
 
The practice of weight inclusivity extends itself to the concept of respectful care. Respectful care means bringing an end to weight discrimination, stigma and bias.
 
 
 
According to a 2017 article published in ​BMC Medicine Journal​, ‘stigma has direct and observable consequences for the quality and nature of services provided to those with obesity, leading to yet another potential pathway through which weight stigma may contribute to higher rates of poor health’.
 
If we are to appropriately address higher rates of poor health for those with larger bodies, weight inclusive health initiatives need to be brought to the forefront of our healthcare practices.
 
It’s important to note the ​myths ​and assumptions that surround weight inclusive health practices, as misinformation is what continues to undermine its place within our health care settings.
 
The most common misconception being, is that every person is healthy regardless of their size. In actuality, the practice of weight inclusivity within health care settings asserts that every person deserves the right to pursue health regardless of their size or weight.
 
Health should be a resource that anyone can access at any given time, and not reserved for those who our healthcare gatekeepers deem as worthy.
 
Now is the time for us to reject weight-based discrimination, champion access and equity, and put forward a very simple demand: good medical care, despite weight or the perception of an unhealthy weight.
 
We have a long way to go when it comes to ensuring that each and every person’s experience within the medical system is a positive one.
 
It is my hope that as health practitioners come to understand the principles of weight inclusivity, they will all eventually come to the same conclusion; everyone deserves appropriate and respectful health care, regardless of their size.

AUTHOR BIO

Madelaine Cherrington

Madelaine is a young woman living in Sydney, with a background in communications and public health. Madelaine has a passion for addressing stigma and inequity within health care settings. She also hosts and produces her very own podcast, If You Don’t Mind.

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