Weight Bias in Healthcare and How to Find Inclusive Practitioners
Weight bias in healthcare is a reality in our world today. According to a recent survey, 40 percent of U.S. adults experience weight bias, a dramatic increase from 12 percent back in 2006.
This worsening epidemic can affect all spheres of life, the data continues, from education and relationships to healthcare and employment.
This is specifically dangerous when experienced in healthcare. Those who encounter weight bias face a higher risk of wellness disparities and all-cause mortality than folks in smaller bodies.
Weight bias can also take several forms, research points out, whether it’s a demeaning interaction with a physician or an outright dismissal from a healthcare facility.
Let’s discuss the various impacts of weight bias and how to find more inclusive practitioners.
The Prevalence of Weight Bias in Healthcare
The numbers speak for themselves. Researchers at the University College London report weight bias tendencies among :
69% of doctors
46% of nurses
37% of dietitians
What’s more, nearly 85 percent of doctors are reluctant to perform even routine examinations on women with obesity. As such, the researchers found that many clinical environments do not offer accessible, equitable healthcare with size-inclusive physicians in a non-judgmental space.
Forms of Weight Bias Among Healthcare Professionals
There are two primary forms of weight bias:
Implicit bias: based on lack of awareness, inadequate training, or unconscious beliefs.
Explicit bias: based on conscious negative attitudes.
When it’s allowed to continue unchecked, both implicit and explicit weight bias can turn into weight stigma, which is the mistreatment or discrimination of folks in larger bodies.
Here’s how weight bias often shows up in clinical settings:
Disrespectful communication from doctor to patient
Inadequate physical accommodations (small chairs)
inadequate clinical materials (gowns, cuffs, etc.)
Shaming or blaming a patient for health conditions
Attributing all medical symptoms to weight or body size
Denial of treatment or limited access to quality care
Inaccurate assumptions (unhealthy diet or exercise habits)
The Impacts of Weight Bias in Healthcare
How do these attitudes play out? The Health Expectations Journal surveyed patients who have dealt with healthcare-related weight bias at least once to ask them a series of questions about their experiences. Here are just some of the responses they gave:
94% have been told to lose weight as a catch-all treatment.
74% have been labeled as binge eaters—even if they’re not.
68% have been prescribed a dietary plan they never requested.
49% have been treated as lazy because of their weight.
46% have been treated as incompetent because of their weight.
39% have been on the receiving end of cruel weight-centric remarks.
Folks with intersectional racial, gender, or socioeconomic identities are even more susceptible to weight bias and the chronic stress levels that come from multiple sources of discrimination. This persistent stress can worsen health outcomes due to factors such as ineffective treatments, internalized shame, misdiagnoses, lower satisfaction in life, and loss of trust in medicine or lack of adherence to wellness-promoting behaviors.
More Weight
Bias Equals More Health Issues
The more frequently a person encounters weight bias in clinical environments, the higher their risk could be for the following mental and physical conditions:
Inflammation
High blood pressure
Immune dysfunction
Hormone imbalance
Type-2 diabetes
Cardiovascular issues
Hypervigilance
Emotional distress
Low self-esteem
Depression or anxiety
Body dissatisfaction
Eating disorders
The Benefits of a Weight-Inclusive Healthcare Model
To help combat the harmful effects of weight bias, some clinicians are shifting towards a more weight-inclusive healthcare model.
One such paradigm is Health at Every Size (HAES), which emphasizes non-judgmental, compassionate wellness interventions through a holistic lens that takes the entire person, not just their outward appearance, into account.
A recent study from Frontiers in Nutrition found a positive correlation between HAES and higher rates of mental, emotional, and physical well-being.
The research also shows that folks who receive HAES-aligned care are often more motivated to stick with healthy choices (e.g. intuitive eating, joyful movement, or gentle nutrition) than they might be otherwise.
That’s because this framework does not position weight loss as the objective. Rather, it focuses on cultivating sustainable habits tailored to each patient’s unique needs.
HAES also rejects the archaic and inaccurate notion that BMI is a reliable marker for cardiometabolic health, opting instead to empower and educate folks across the weight spectrum on how to care for their own bodies.
5 Tips for Finding Inclusive Healthcare Practitioners
Inclusive healthcare means more than access. It means being treated with respect, listened to without bias, and supported as a whole person.
Whether you’ve faced discrimination, stigma, or just want care that aligns with your values, these five tips can help you find practitioners committed to providing affirming, equitable treatment.
1. Access inclusive community directories.
It can be hard to locate inclusive, HAES-aligned practitioners in mainstream healthcare listings, so tap into trusted community resources whenever possible. Fat-positive, anti-fat, and gender-affirming forums, social media communities, or local support groups may have recommendations for inclusive and affirming practitioners in your area.
Check out our list of 15 Directories to find Inclusive Therapists, or this list of weight-neutral healthcare providers as a starting place.
2. Make sure the clinician is HAES-aligned.
Narrow your search to clinicians who specifically describe themselves as HAES-aligned. If they mention the Health at Every Size Principles or use terms such as weight-neutral, size-inclusive, and stigma-free on their websites, that’s a positive sign. Before committing to a provider, you can also screen them for HAES alignment with these questions:
Are you a weight-neutral, size-inclusive, or non-diet clinician?
How do you prescribe healthcare interventions, regardless of a patient’s size?
Are you familiar with the concepts of weight bias and stigma in medicine?Do you have experience treating folks who are often stigmatized for their size, or who suffer from issues like eating disorders or poor body image?
Do you adjust equipment (e.g. cuffs, gowns, etc.) to accommodate larger bodies?
3. Ask about continual anti-bias training.
Research shows that when healthcare practitioners are trained to notice weight bias in clinical spaces, it evokes more compassion in them, along with reflection and recognition of how they can be part of a more holistic solution moving forward.
During your consultation, ask the provider about their commitment to weight-neutral education and public advocacy efforts.
Here are some ways to find out if doing this work is a continual priority for them:
The clinician links to current weight-inclusive research and resources on their website.
The clinician invests in anti-bias training courses, workshops, and other educational curricula or advocacy programs.
The clinician allies themselves with organizations or educational initiatives aimed at promoting inclusive healthcare models.
The clinician’s office environment reflects weight and size inclusion (e.g. accessible furniture and equipment, sensitive staff policies).
4. Pay attention to their communication.
When you check out a provider’s website or call their office, listen to the language they use. How a physician shares information is often indicative of their approach to healthcare, so keep an ear out for these inclusive communication practices:
The clinician talks about lifestyle practices and holistic wellness metrics, not your size, weight, or BMI, as the central focus of treatment outcomes.
The clinician conducts a thorough intake of your nutrition and exercise habits, hormonal balance, sleep hygiene, stress and energy levels, relationships, and genetic history, or other non-weight factors that can influence health.
The clinician uses neutral, non-judgmental communication (e.g., “I need to measure your blood pressure,” instead of “Let’s see if your weight is in a healthy range”).
The clinician is open to discussing issues such as trauma, mental health, body image concerns, or eating disorder behaviors.
The clinician invites dialogue about the structural and social determinants of health (e.g., income, environment, community, education, government policies, discrimination, etc.) rather than blaming all symptoms on weight.
5. Advocate for yourself.
Once you select a practitioner and make the first appointment, be aware of any red flags that surface during interactions with nurses, physicians, or other staff members and trust your instincts.
You have the right to be heard, reclaim autonomy over the experience, and leave if a practitioner is:
Dismissive of your health goals.
Insensitive to your concerns.
Makes disrespectful comments about your weight and size.
Simply unwilling to focus on whole health instead of your weight or size.
Not sure how to speak up for yourself? Here are a few helpful resources:
Break Free From Weight Bias with Project HEAL
Weight bias in medicine is more than just an inconvenience; it’s a serious problem that causes mental and emotional distress, worsens physical health outcomes, exacerbates stigma, and contributes to inequitable care models.
Whether implicit or explicit, the downstream effects that weight bias can have on patients are reason enough to push for more inclusive and accessible alternatives. If you’re searching for weight-neutral, affirming treatment support, Project HEAL may be able to help. Learn about our treatment programs and browse our resources.
