Weight Neutral Healthcare: Cause for a Pause?

Charles Deburau as Pierrot ListeningAre we listening to each other? Not too much, it seems. It’s not even clear that we’re listening to ourselves. Often, we’re too busy making a point. Right now, we’re hearing a lot of people making points about weight neutral healthcare. Dani Donovan, a 30-year-old patient advocate with binge eating disorder recently found a medical office where they take it seriously.

In the waiting room, she found a stack of cards that patients could hand to their provider saying:

“Please don’t weight me unless it’s (really) medically necessary.”

Donovan has often avoided medical appointments because her binge eating disorder makes routine weighing a stressful experience. Using one of these cards, she started a fruitful and empowering conversation with her provider.

Apparently we need cue cards to remind us to listen to one another. So be it.

New Research: Confusing and Contradictory Messages

A new analysis in Body Image suggests Donovan is not alone in finding conversations about weight neutral healthcare to be a challenge. Shoa Zafir and Natalie Jovanovski examined the discourse in 63 studies of weight inclusive health research. In short, they found a mess:

“The language used in academic literature is creating confusing and contradictory messages about weight and weight-neutral approaches to health (like the HAES® approach).”

They called out three key problems:

– Continued use of stigmatizing labels like obese
– Paradoxical language like flexible restraint
– Focus on individual responsibility and blame

Pointless Arguments

So perhaps we should not be surprised to witness so many pointless arguments about health and weight. Even now, when many people are seemingly done with endlessly trying to lose weight, it’s tough not to wind up arguing about it.

When body positive influencers lose weight, they can find themselves vilified. Katie Rickel, CEO of Structure House, suggests this is a mistake:

“What people are misunderstanding is that these influencers may very much love themselves and their bodies and still want to lose weight if they think that will help them in other ways.”

A Nonsensical Jab

Likewise we see a nonsensical jab at HAES® stuck into draft guidelines on weight management posted for public comment by the Academy of Nutrition and Dietetics. The last of a long list of recommendations tells dietitians not to use the HAES approach “to improve BMI.” Of course not. HAES is all about pursuing health without pursuing weight loss goals. So HAES simply doesn’t belong on a list of recommendations for weight management.

The only purpose it serves is to fuel an argument. It helps to ensure that people will not stop and listen to each other. We need less of this. We need to stop and listen to the needs of people who think differently about weight and health. Different people have different needs and they deserve respect.

Click here for more about the cue cards for discussions about weight neutral healthcare. For the study of language used in weight inclusive healthcare research, click here. Finally, you’ll find insight on the experiences of body positivity influencers who lose weight here.

Charles Deburau as Pierrot Listening, photograph by Felix Nadar / WikiArt

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February 23, 2022

One Response to “Weight Neutral Healthcare: Cause for a Pause?”

  1. February 23, 2022 at 12:29 pm, Victoria Bruce-Estrada said:

    Great article Ted. I appreciate you bringing light once again to the daunting medical appointments, that those of us with obesity face. If the cue cards help, so be it. But those would only exist in an office that already had a heightened sensitivity for patients that struggle with their weight and body image. The offices that most need them would most likely be opposed and carry the heaviest bias. Education that yields a true shift in belief systems still feels out of reach.