Scheduling a doctor’s appointment for someone in a fat/larger body is nerve wracking! Some thoughts that used to run through my head before I found a size inclusive provider were:
A lot of “what ifs.” The lexapro was working overtime AND these fears are VERY real for someone who is not in a straight sized body seeking medical care.
Picture this: you walk into a doctor’s office for the common cold, and somehow the conversation shifts to your body mass index (BMI) instead of your runny nose.
Sounds familiar, right? That’s weight stigma in action. Weight-normative health care providers often focus on body weight alone, assuming it’s the root of all health issues. This can lead to weight discrimination, which affects the quality of care for those in larger body sizes. It’s not just annoying—it’s seriously harmful.
The constant focus on weight, instead of other physiological or health-related factors, can leave people feeling ignored and dismissed. Plus, it adds unnecessary stress to what should be a supportive environment. So, if you’ve ever felt like your health concerns are brushed aside because of your size, you’re not alone.
Weight bias and stigma are unfortunately all too common in health care settings. 42% of U.S. adults report facing some form of weight stigma, such as being teased about their weight or treated unfairly because of it. Physicians and coworkers are often cited as some of the most frequent sources of this discrimination.
Many health care professionals, often unconsciously, stigmatize patients based on their size. This can mean they spend less time with patients in larger bodies, focusing more on weight than on addressing actual physiological or health-related concerns.
Internalized weight bias also plays a big role here, as those experiencing weight discrimination may start to believe the negative stereotypes themselves, impacting both their mental and physical well-being. This kind of bias not only compromises the quality of care but also makes seeking health care a more stressful and daunting experience. It’s crucial for medical staff to move beyond the focus on body weight and provide care that treats the whole person.
The consequences of weight bias and stigma affect both physical and mental health. When health care providers fail at addressing weight bias, patients often experience bias due to their body size, which can lead to a host of negative outcomes.
Weight-based discrimination is linked to disordered eating habits, reduced physical activity, and an overall avoidance of health care settings. This social stigma associated with body weight not only discourages people from seeking medical care, but may even result in weight gain over time. Make it make sense!! We don’t want to go to the doctor’s in the first place, and then when we do muster up the courage to go, we’re shamed.
Ironically, instances of weight bias, rather than motivating healthier behaviors, tend to reduce health-seeking behaviors and lead to increased weight. For example, people who experience bias are more likely to engage in disordered eating patterns, such as binge eating, regardless of their BMI.
The stress of weight bias impacts individuals physiologically, too, raising cortisol levels, which can lead to chronic health issues.
Additionally, weight bias among health care providers contributes to underdiagnosed mental health concerns. In particular, eating disorders such as anorexia and bulimia are often overlooked in larger-bodied patients due to the stigma associated with weight. Guess what the difference is between an Anorexia diagnosis versus an Atypical Anorexia diagnosis? Weight stigma.
Addressing weight bias in health care is critical to improving health outcomes and fostering a more inclusive approach to patient care.
If you’ve faced bias due to weight, you’re not alone. Bias tends to impact how you engage with health care and can discourage seeking the support you deserve. It’s important to know that there are steps you can take to protect your well-being and navigate these challenges. Here are a few things I’ve done to make sure I get the care that I need:
I’ve tried MANY PCPs before I found my current PCP. This process is exhausting AND you don’t have to do it alone! You can always ask a provider on your team to call ahead and ask some questions- you’d be surprised how forthcoming the front desk staff can be at giving up the tea.
Some questions you can ask include:
Hand this to the front desk when you check in or give it to your dietitian for them to fax it to the office before your appointment. Request that the nurse and PCP read it before they meet with you, and ask for it to be saved in your file. Here is our free “I’m Requesting Weight Inclusive Healthcare” sheet.
Reminder that this PCP is there for YOU. You get to direct the appointment. Have your questions ready so that you don’t have to think on your feet while anxiety may be high already.
Speaking about my own experience, every time I went to the doctor (the one who wasn’t weight inclusive), my BP was always high. I’d get lectured about exercise, nutrition, and weight, without them even knowing anything about me.
I purchased an at home blood pressure monitor and take my BP about once/week or once/every other week when I’m not anxious and record it in the notes app on my phone to bring to my appointments.
Now that I do have a weight inclusive provider, my BP is normal in the appointment. It’s funny how having affirming, weight inclusive, and trauma informed care feels safe for our nervous system- WHO WOULD’VE THOUGHT *major eye roll*
Have the appointment with your treatment team the same day if possible to debrief! This can be especially helpful since the experience is fresh in your mind and often, we’re holding ourselves so tightly that it can be helpful to have someone who is a safe space to unwind with.
If it goes well, congratulations! You’ve found yourself a solid healthcare provider who is prioritizing HEALTHcare, not WEIGHTcare, which is how it should be. If it doesn’t go well, this is just an indicator that the PCP hasn’t done their own work of unpacking their own biases, which is unfortunate and disappointing.
This means NOTHING about you and only provides us information that the provider wasn’t for you. On to the next one! (with the help of your treatment team, of course). Also, it’s ok to be sad, disappointed, angry etc. A good cathartic cry is helpful, AND, again, it’s not you, it’s them.
A few reminders for yourself if you need them:
We’re sending you so much compassion.
If you don’t have a provider on your team who will advocate for you- let us be that person. Contact us here to schedule your first appointment
Megan is a weight inclusive registered dietitian and Certified Intuitive Eating Counselor. She is the founder and director of A Soft Place to Land, a multidisciplinary group practice based in Lehigh Valley, Pennsylvania that specializes in eating disorders, chronic dieting, and body image care. She is fiercely on a mission to be a loud advocate for ethical care of every BODY. Megan’s goal is to provide a weight inclusive and trauma informed safe space with an emphasis on social justice, fat liberation, self-exploration, and compassion. When she’s not taking down the patriarchy, you can find her spending time with her dogs outside, gardening, and painting plant pots!
Hi, I'm Megan and I'm the owner and founder of A Soft Place to Land.
We provide a weight-inclusive and trauma-informed safe space with an emphasis on social justice, non-diet nutrition, fat liberation, intuitive eating, self-exploration, and a Health at Every Size® philosophy.
Through nutrition therapy and mental health therapy, we work with you as a whole person to provide highly individualized care, as you are the expert of your own body.
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