FNCE: Starting with Lived Experience in Obesity Care

All too often, the healthcare experiences of people living with obesity are appalling. And the reason is simple. For many professionals, all they can see is a fat person. More often than not, the answer to every health problem is “you should lose some weight” – irrespective of any consideration of the whole person. So we got a little thrill when we saw that the Academy of Nutrition and Dietetics has put the lived experience in obesity care right up front at their big annual meeting – FNCE.

In fact, Patty Nece, Vu Pham, and Nikki Massie spent an hour and a half describing their lives. They talked about family, healthcare providers, personal challenges, successes, and insights.

The bottom line here is actually quite simple. If a health professional wants to provide good care, they had better take the time to understand this lived experience of obesity. Because this is 42 percent of the population. It’s an even larger percent of the people who need care.

Without that understanding, they are unlikely to provide competent care.

Nikki Massie

Massie is Deputy Director of Digital Marketing at Corus International, a nonprofit dedicated to global issues of health, poverty, and climate. In her spare time, she serves on the board of directors for the Obesity Action Coalition. She explains a bit of her journey:

“After struggling with my weight and my health for my entire life, I underwent Roux-en-Y gastric bypass in 2008. In the nearly 14 years since, I’m proud to have been able to maintain 100 pounds of weight loss, even while struggling with other other health issues – like alopecia and early stage breast cancer.

“It was very challenging when my two almost grown up daughters were starting to address their health and weight. I’m a bariatric patient. And my partner had end-stage renal disease. So that meant there were very few meals we could eat one meal and everyone had the same thing. I wish we had a family dietitian to help us work it out. Because meals are more than just food. You share a meal and you talk about things.”

Patty Nece

Nece is an attorney in the U.S. Department of Labor and also chair of the Obesity Action Coalition. She explains the path she’s followed:

“I’ve had obesity my entire life. I can’t remember a time when I wasn’t one of the biggest kids in the room. Or one of the largest adults in the theater, or the restaurant, or at work. It’s led to a lot of issues for me experiencing bias and stigma. It’s had an impact on me throughout my life.

“I eventually found a wonderful obesity medicine specialist who has helped me medically manage my condition. But I have to tell you that the pandemic has wreaked havoc. So I along with others have experienced weight regain.”

Vu Pham

Pham is the office manager for Trinity Bariatric Surgery in Buffalo, NY. He described some of his experiences:

“I’ve had obesity pretty much my entire life as well. But it took becoming an office manager for a bariatric surgery practice to realize some of my own biases. These are stigmas that I tried to push down or ignore as if they weren’t there.

“Eventually becoming a BSCI support group leader, I got to really know other people’s perspectives and learn more about myself. I started recognizing these things in my own children and other children we interact with. I realized this doesn’t have to be something we do alone. It can be very lonesome journey.”

Critical for Providing Good Care

“This is a perspective that every RDN should understand,” said Jeannie Blankenship, a dietitian and VP for policy at the Academy. In fact, it’s a challenge for every healthcare professional and every professional organization. For too long, the lived experience of people in larger bodies has been invisible. Too often, even today, professionals discount it.

But soon, it will be impossible to provide competent care without bringing an understanding of the lived experience with obesity. A provider who dismisses the perspective of more than 40 percent of their patients is simply not living up to the emerging standard for acceptable care.

Click here for more on the lived experience with obesity, here, here, and here for more on reducing weight bias and stigma in healthcare.

The Lived Experience of Obesity, panel at FNCE

Subscribe by email to follow the accumulating evidence and observations that shape our view of health, obesity, and policy.


October 18, 2021

One Response to “FNCE: Starting with Lived Experience in Obesity Care”

  1. October 18, 2021 at 10:47 am, Mary-Jo said:

    Really great to see this. As a young dietitian with obesity, I often, actually, felt condescension, even pity from people in my profession. I lost 100 lbs. and kept it off, working hard at it, but, most importantly with much enlightenment, understanding, and support from endocrinologists, diabetologists, and others working in the field of obesity then, doing research, who KNEW it was multifactorial, not just ‘eat less, move more’ and who valued me as a professional who understood the dynamic. I got a reputation as an RD who was very effective at helping people with obesity, resulting in many referrals, in the hospital system, but also from community GPs. But, I was often criticized from my immediate dietetic supervisors and colleagues for being ‘too personal’ with patients just because I would ask about other issues than their dietary intake.