What Does Weightinclusive Health Care Mean? A Dietitian Explains What Some Providers Are Doing To End Weight Stigma

Holistic weight management means focusing on improving your health without necessarily losing weight.

This includes practices such as eating for overall health rather than counting calories. This may include prioritizing stress-reducing activities, quitting smoking, limiting alcohol consumption, and engaging in enjoyable physical activity.

A holistic approach to health addresses the harm caused by weight stigma.

People with larger bodies often suffer from weight-related stigma, such as: B. Discrimination, discrimination, negative stereotypes and judgment from others, including doctors and other health care providers. Over 40% of American adults of all body sizes report weight stigma in their daily lives.

Avoiding this stigma is the main reason people in the United States travel long distances to lose weight. Market data shows that Americans will spend $72.6 billion on weight loss products and programs by 2021. Weight loss efforts also start early: About half of high school students in the United States say they have tried to lose weight.

I am a nutritional epidemiologist and registered dietitian who studies the effects of weight stigma and works to develop comprehensive weight-related nutritional interventions.

My own practice and research approach initially focused on weight. A weight-centered approach focuses on weight loss to achieve health and is widely accepted in healthcare settings around the world. After working in the restaurant industry for over ten years, I have seen what I believe is a weight-based approach that can harm individuals and communities. That's why I began to take a holistic approach to weight in practice and research.

Say goodbye to the “less weight means better health” doctrine.

There are many studies and health reports indicating that high body weight is linked to many long-term health problems such as high blood pressure and type 2 diabetes.

Therefore, there is a common misconception that the holistic approach ignores the patient's health problems. However, weight care advocates argue that a weight-inclusive approach can reduce health problems by reducing weight status and promoting health equity. They also recognize that there is a connection between high and low body weight and various health problems.

The dogma that weight loss equates to improved health is being challenged by public health researchers and healthcare providers. Scientists and doctors are calling for a paradigm shift away from emphasizing weight, weight status and body mass index (BMI) as indicators of health.

Advocacy groups like the Society for Size Diversity and Health have long promoted a “health at all sizes” approach. This weight-based approach emphasizes a socially equitable definition of health and supports equitable health care regardless of weight status. The American Medical Association recently released a statement explaining the advantages and disadvantages of using BMI as a clinical measure.

Evidence for comprehensive weight management

Important research shows that quitting smoking and reducing alcohol consumption, regardless of body weight, can prevent disease and support overall long-term health. For example, a clinical trial and a systematic review of 152 observational studies found that a nutrient-rich diet and low to moderate alcohol consumption reduced the risk of death for everyone.

Another example: One of my clients with high cholesterol said that a lifelong focus on weight loss led to weight loss and gain, eating disorders, inconsistent and excessive exercise, and physical inactivity. After adopting weight-conscious practices like eating a high-fiber diet and increasing exercise instead of focusing on weight loss, their cholesterol levels return to normal.

Both holistic and weight-focused approaches can include dietary changes, increased physical activity, and stress reduction as core components of disease management and prevention. However, a holistic approach to weight helps end weight-related stigma and recognizes that factors such as social status, culture, diet and health care, collectively referred to as determinants of societal health, have a significant impact on body weight, body shape and behavior have. Measure. . Even if a person can adhere to a strict diet and exercise program, there will always be structural, political, and other factors affecting health and weight that are beyond the person's control.

Additionally, there is evidence that people who lose weight generally do not have better long-term health and do not lose weight.

Get comprehensive weight loss care

There are many things people can look for in a weight management practice.

Find the following healthcare providers:

• Make weight checks optional during routine visits.

• Treat the patient's symptoms rather than telling them to lose weight.

• Offer older patients the same treatment as thin patients with similar health problems.

• Use measures other than BMI to diagnose health problems, such as laboratory results.

• Ask permission before discussing weight with patients.

For additional resources on general weight care, see the health booklets included in each volume. Test your weight bias by taking an online quiz that focuses on subtle connections to weight.

This article is reprinted from The Conversation, an independent, nonprofit news organization that brings you facts and analysis to help you understand our complex world.

Author: Lauren Butler, Texas State University .

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