You have probably been asked to “hop on the scale” at a doctor’s appointment -likely every doctor’s appointment regardless of if the purpose of the appointment was seemingly related to weight or not. This presumably harmless checklist item can actually be quite the opposite for someone who is struggling with an eating disorder, disordered eating, or body image issues. Statistics show that at least 9% of people have an eating disorder at some point in their life (1). So for a doctor who sees 20 patients per day, that’s about two people per day that may be negatively affected by this seemingly mundane task.
If the person described above doesn’t sound like you, I’m going to describe a fictional experience of a patient to paint a better picture of what the lived experience of getting weighed can be like.
Example of a fictional experience (but likely has happened many times!)
Last month when you saw your physician they recommended that you lose a certain percentage of your body weight. You don’t remember exactly what condition it was for because you have a few health concerns and the physician didn’t make it clear which one this was targeting. As soon as you left the office, you started googling and before you knew it you were diagnosing yourself with being at high risk of pre-diabetes, high blood pressure, and 5x increased likeliness of all cause mortality. This really scared you because you care about your health.
You started skipping breakfast to cut back on calories and increased your movement significantly. You were so proud of yourself and couldn’t wait to share the news with your doctor, but when you got on the scale your weight hadn’t budged. Not only are you worried about your existential health, but now you are nervous about what your doctor is going to think because on the scale it looks like you haven’t even tried!
The doctor comes in and immediately brings up your stagnant weight. You start to state your case, but it all feels overwhelming so you just sit there, not really listening to what he’s saying, trying to figure out how you are going to be successful this time at losing the weight because you have to for your health and now your self-esteem after this doctor has made you feel insecure.
When you get back in the solace of your car, you reflect that the shame you feel during this appointment makes you never want to return to the doctors’ again.
In the rest of this article I will define weight inclusive care, discuss the differences between weight inclusive and weight neutral care, help you to determine if you should seek out a weight inclusive provider, and give suggestions on how you can go about searching for a weight inclusive provider if you choose to do so.
What is Weight Inclusive Care?
Weight inclusive care is an approach to health that shifts the focus away from weight. Weight is no longer viewed as an indicator of health.
Instead of weight-related intentions, goals are encouraged to be related to things like well-being –improved sleep quality, increased energy, decreased stress–or improved biomarkers of health such as lowering hemoglobin A1C or ensuring that your blood pressure is in a health-promoting range.
Indicators of health that can be focused on in an weight inclusive model of care are listed below:
- Movement/Exercise
- Nutrition
- Quality of sleep
- Stress levels
- Vitals (blood pressure, heart rate)
- Labs (blood sugar, cholesterol…)
- Presence/absence of disease or illness
What is the Benefit of Seeing a Weight-Inclusive Provider?
Well, for a lot of people it is relieving to no longer have weight be the main focus of their health. This means no longer being shamed for their weight! This will likely motivate patients to come back to their provider and possibly even want to come back to their provider. When healthcare providers eliminate the conversation around weight they are inadvertently making room for other topics to be addressed. There is more time to discuss the things that the patient is concerned about such as ongoing knee pain because the canned weight loss advice is no longer a conversation that is going to be had. Instead, there is time to discuss things like how to increase strength and mobility in the knees or what types of shoes are targeted for improving knee pain.
Should I Start Seeing a Weight Inclusive Provider?
I’d recommend seeing a weight inclusive provider if you’ve ever had the following experiences:
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- Feeling a negative emotion such as guilt or shame after leaving a healthcare appointment related to seeing, hearing, or discussing your weight with your provider
- Leaving a healthcare appointment feeling like the only solution to your health concern(s) is weight loss
- Having the impression that weight was the primary focus of the appointment
- If you would like weight to not be the focus of your health
- If you don’t want to be weighed and want to avoid stating your case as to why you don’t want to be weighed
- If you have a history or active eating disorder
- If you just want to
Is Courage to Nourish Weight Inclusive?
Yes! All of our dietitians practice from a weight-inclusive model. Weight can be thought of as a “side effect” rather than the goal. The goal is working on improving health promoting behaviors. That being said, during this journey, weight may go up, down, or stay the same. This can be scary and hard for a client to tolerate–that’s why we are here to support you every step of the way!
Final Thoughts On Seeking Out a Weight Inclusive Provider
Thank you for reading this blog on the benefits of weight inclusive care. Weight inclusive care offers a respectful, supportive approach to health that focuses on behaviors—not the number on the scale. If you’ve ever felt shame or frustration at a medical visit, know there’s another way. At Courage to Nourish, we’re here to support your health without weight being the focus.
1. Deloitte Access Economics. The Social and Economic Cost of Eating Disorders in the United States of America: A Report for the Strategic Training Initiative for the Prevention of Eating Disorders and the Academy for Eating Disorders. June 2020. Available at: https://www.hsph.harvard.edu/striped/report-economic-costs-of-eating-disorders/.
We are here to support your nutrition goals!
Courage to Nourish is a group of eating disorder specialized dietitians. We have in person locations in Alexandria, Virginia, Columbia, Maryland. and College Park, Maryland. We offer virtual services across the state of Virginia, Washington DC, Pennsylvania, and Colorado. We offer individual nutrition therapy. As well as support groups. We would love to guide you in building a better relationship with food.
Contact us for more information. And to schedule a discovery call. Also, sign up for our client or clinician newsletter!
Check out our eating disorder quizzes:
Haley joined Courage to Nourish because she shares an anti-diet, weight neutral philosophy in her treatment strategies and she wanted to work in an outpatient setting to foster deeper connections with clients focusing on helping clients repair their relationships with food
and their bodies. To learn more about Haley and her practice style, click here.