Body Positive Medicine at NWIM: Why Weight-Neutral Care Matters

Northwest Integrative Medicine is a primary care home for you to safely be seen and heard as a whole person. That includes our new Body Positive Medicine focus.

Now more than ever, our society is moving towards a culture of acceptance, tolerance, and diversity. We at NWIM believe that people from all walks of life should have access to unbiased, supportive healthcare that treats the whole person. This applies not just to racial and ethnic background but also to gender expression, sexual orientation, and body size. We believe that your medical care should be as inclusive and supportive as possible and are actively working to cultivate a clinical setting that reduces negative attitudes towards people in bigger bodies. More phrases that apply to this conversation are Health at Every Size®, body positivity, and weight-neutral healthcare. There are many reasons that we are increasing our focus on weight-neutral, body-positive care for individuals in all body shapes and sizes – and there are many reasons why you might benefit from a weight-neutral approach to your care!

Larger People Experience Weight Stigma

Research shows that individuals in bigger bodies face regular discrimination in healthcare settings and in everyday life. One recent study found that over half of participants, all of which were in the obese BMI category, experienced at least one form of discrimination regularly. In the study, rates of weight-based discrimination were higher than other forms of discrimination, including race, gender, and sexual orientation.

Weight discrimination, also referred to as weight bias or stigma, is also very common in the medical world. Many doctors have a negative perception of patients with higher weights, and this impacts their ability to provide good care. Unsurprisingly, patients in bigger bodies often report poor experiences at the doctor’s office and are less likely to go to the doctor’s office because of this. Just like doctors are trained to treat people of all races, genders, and ages with respect, medical schools are starting to talk about how to treat patients in bigger bodies with more respect, too. Working to reduce all discrimination and bias in healthcare is a long-term project for all medical providers, but it’s an important thing to do!

Weight Stigma Impacts Physical & Mental Health

This issue goes way beyond feeling comfortable in the doctor’s office! Research has shown that patients who experience weight stigma have worse health outcomes of all types. Some health outcomes that have been linked to weight stigma include increased risk for diabetes, higher inflammation, and higher risk of depression and anxiety. Not to mention, experiencing weight stigma leads to worse self-esteem and body image amongst people in higher weight groups. So, when we assume that people in bigger bodies are at higher risk for poor health, it’s actually a lot more nuanced than that. There is even more to say about this, but we’ll save that for another time.

Weight Isn’t a Good Indicator of Health (and It’s Really Difficult to Change Long-Term)

Here is a particularly tough (and sometimes touchy!) topic: despite what you’ve probably heard from the media, weight and BMI aren’t actually a very good indicator of our health. While BMI has been used to describe body size and health in the past, there is more and more research demonstrating that when we account for other factors, the relationship between BMI and chronic disease changes. The factors that change this relationship include weight stigma and access to good healthcare – so we see that people at higher weights are not at increased risk for chronic disease when we account for the discrimination they face. Kind of mind-blowing, right?

Above and beyond this scientific challenge, we have not as a society been able to develop a guaranteed weight loss solution, with the vast majority (95+%) of dieters re-gaining the weight they lose within 2 years. Even with higher levels of intervention, like with weight loss surgeries, the outcomes aren’t guaranteed to be effective in the long term. So, as evidence-based doctors, it makes it difficult to recommend weight loss and feel good about it.  

So, What Does Body Positive Medicine Mean at NWIM?

All of this dense scientific information translates to action and attitudes at our practice. We care about your wellbeing and seek to provide the best care possible, including providing a safe space in which you will never face discrimination or judgment. NWIM is working on making the office as accessible to people of all sizes and welcome patients looking for a HAES-friendly or weight-neutral practitioner to establish care with our clinic. For us, a body positive practice means that we accept and celebrate the natural diversity of weight, never judging or assuming a patient’s health status by their body size.

Body Positive Medicine providers at Northwest Integrative Medicine are committed to the following approach:

• Limiting weight-based conversation to rare cases when weight is related to the progression of a health condition.
• Avoiding the recommendation to lose weight for health or to utilize a restrictive diet with the goal of losing weight.
• Using inclusive language that does to make you feel shame or guilt about your weight or appearance. 

With myself and Dr. Corn coming on, we are going to increase the amount of content from the practice that promotes self-love and self-acceptance, regardless of body shape or size. Topics we hope to cover include:

• Advocating for weight-neutral care at your (other) doctor’s office
• Body positive resources and activities in the Portland metro area
• Breaking the diet cycle to start eating intuitively
• All bodies are bikini bodies! Living a full life in a bigger body

Interested in more content related to our new Body Positive Medicine specialty? Let us know!

References

1. Pearl RL, Wadden TA, Tronieri JS, Chao AM, Alamuddin N, Berkowitz RI. Everyday discrimination in a racially diverse sample of patients with obesity. Clin Obes. 2018;8(2):140-146.
2. Sutin AR, Terracciano A. Perceived weight discrimination and obesity. PLoS ONE. 2013;8(7):e70048.
3. Phelan SM, Burgess DJ, Yeazel MW, Hellerstedt WL, Griffin JM, Van ryn M. Impact of weight bias and stigma on quality of care and outcomes for patients with obesity. Obes Rev. 2015;16(4):319-26.
4. Penney TL, Kirk SF. The Health at Every Size paradigm and obesity: missing empirical evidence may help push the reframing obesity debate forward. Am J Public Health. 2015;105(5):e38-42.
5. Tomiyama AJ, Carr D, Granberg EM, et al. How and why weight stigma drives the obesity ‘epidemic’ and harms health. BMC Med. 2018;16(1):123