Addressing Weight Stigma with Your Provider

Elms, Cindy

By Cindy Elms, RDN, for Weight Stigma Awareness Week

So many wonderful people are speaking out against weight stigma in support of weight neutrality and body positivity. Some teach professionals the importance of acknowledging weigh bias to improve caregiving and others publicize the real research results on weight issues related to health. So I will leave that to them for now and focus here on you, the one who wants to feel safe in your provider’s office while getting the care you need.

You love your doctor. She helped you get on the right medications for asthma, and you owe it to her that you have not been to the ER in 6 months. But still, every time you meet with her, she mentions that:

“You would feel so much better if you just lost some weight.”

You don’t disagree with her because these words are not new for you and this nagging thought has been in your head for years. She has even offered to send you to a dietitian who can help you lose the weight and has offered you medications to decrease your appetite. The temptation is strong to make a go at weight loss just one more time. All of the attempts at diets and exercise have left you feeling out of control of your own body and so embarrassed.

But you are worn out and feel like a failure. 

And recently, you are learning that feeling well and having good health do not hinge on weight loss, and it excites you. You knew there had to be a better way to take care of yourself without falling into the trap of extreme methods.

Finally, someone gets it! The blogs of activists and current solid research for this positive body acceptance movement makes you want to tell your doctor what helps you. This news is great, but what stops you from saying something?

I don’t confront my provider because I don’t want to:

  • make them mad
  • hurt their feelings
  • seem ungrateful for their help
  • act like I know more than the professional I am paying for help
  • I definitely don’t want to hear shaming messages about my weight again

If this sounds like you, you are not alone. Twenty to 30% of people will be strongly impacted by weight stigma from professionals but will not speak up for themselves, even when they know the truth about weight and health and want to be treated accordingly.

“Courage starts with showing up and letting ourselves be seen.”

Brene Brown

If this quote scares you, you are not alone. About 99% of people shy away from being vulnerable and speaking the truth, because there is a risk of failure and hurt. And what if it is not your style to confront the weight stigma head on, like some of the activists you have heard speak on the topic?

Reg Reminder WSAW

There are other ways that are also effective and build courage to speak up more easily. Consider these approaches if your provider consistently talks to you about changing your weight.

  • Arm yourself with the truth. Clear up any doubts you have in your own mind about weight and medical issues. What your body looks like is not a true measure of your health and can be misleading. For example, overweight is often “associated” with health issues like diabetes, heart disease and others but is not directly the cause or the cure of these problems. Underweight may be praised as “healthy” but is no indication alone of good or bad health. I recommend these sources to start the education process if you are at this step.
    1. Big Fat Lies: “The Truth about Your Weight and Your Health”. The book is great, and so is this video clip of author Dr. Glenn Gaesser
    2. BEDA, NEDA and AED organizations for research findings
    3. Dr. Rick Kausman Facebook page and author of the book “If not dieting, then what?”
    4. Karin Kratina PhD RD Facebook page and co-author of many books and professional publications.
  • Give yourself permission to ask for time to discuss the topic of your weight as related to your health issues at the beginning of your next appointment. Getting this out in the open first will free your mind to focus on the real health issue. It is more than okay to either refuse to be weighed before the appointment or ask to be weighed “blind” (BACKWARDS) explaining that you don’t want to know your weight.
    1. Take a breath and be curious when the topic of weight comes up. Ask your provider how weight is connected to the medical problem you have. Do your best to stay relaxed and interested as you hear their line of reasoning. If it doesn’t make sense in light of what you have learned, don’t be surprised, but ask more questions. It is not uncommon for wonderful and well-meaning providers to repeat the same things they were taught that no longer apply in light of new research. This is potentially true for physicians, nurses, dietitians, therapists, allied health professionals, psychologists, etc.
    2. If you hear a convincing explanation from the provider, take time to consider it before you just accept it. Discuss with other trusted providers. Ultimately, I predict you will discover more specific and, therefore, effective interventions to improve your well-being. For example, you may be able to add in missing nutrients to increase the strength of your body and ease its workload, or find enjoyable ways to move that help circulation, decrease muscle pain and tension and emotional stresses. Many healthful actions will not lead to weight changes, or they might. But, weight loss is not the primary intervention for any health condition. 
  • And good news, this is a great provider for you…if this provider is someone who is open to your comments, requests and input, then they will most likely also be open to any information you bring them or direct them, too. On the other hand, if you are met with irritation, arguments and close-mindedness, you will have to consider how long you are willing to work with someone who does not care to see all aspects of you and your healthcare needs. If you decide to make a change (also good news), approach your first visit with the next provider like an interview and start at step two above.

If your provider is open to your discussion and wants more information, there are some very helpful toolkits for physicians, dietitians, therapists and other medical professionals. These tools kits really honor professionals for their desire to learn more about weight bias, so they can give the best care to their clients.

View toolkits

Final thoughts–you are worthy

You are worthy of being treated positively by your treating professionals. And, you are responsible for teaching others how you want to be treated. If you still struggle with the thoughts of speaking up for yourself but want to, you may have traits of a highly sensitive person (HSP) and can find help and support at hsperson.com.

Sincerely, Cindy

More about Cindy

Cindy Elms is a Registered Dietitian Nutritionist who is a co-owner of Empowerment Treatment and Counseling Center for Wellness. She specializes in eating disorders, emotional eating, and nutrition education for all ages. Finding the right nutritional path in recovery can be challenging and Cindy is committed to taking the mystery out of nutrition, by supporting her clients in finding their natural eating style for all stages of recovery.

Cindy’s 25 year nutrition experience includes clinical and leadership roles at Remuda Ranch Centers for Anorexia and Bulimia, Rosewood Centers for Eating Disorders and The Meadows. She is a clinical preceptor for dietetic interns and has a special passion to teach and support dietitians and other professionals entering the eating disorder field. She uses this talent on a national level, teaching experiential presentations and workshops. She is a member of the Academy of Nutrition and Dietetics (AND) and International Association of Eating Disorder Professionals (IAEDP).

Cindy has a wealth of professional knowledge and her passion comes from her own recovery experience. She brings compassion and gentleness to her work, combined with her drive and dedication to helping professionals expand their knowledge of eating disorders and effective techniques. Her philosophy is “the way you eat is the way you live”, which she uses to help clients and colleagues bridge the gap of emotional issues and nutrition.

BEDA promotes cultural acceptance of, and respect for, the natural diversity of sizes, as well as promoting a goal of improved health, which may or may not include weight change.  The views expressed by our featured bloggers are their own.