Is Weight Centric Care Helping or Harming Us?
Have you ever noticed how most people correlate weight with health status? Since the Body Mass Index (BMI) was introduced to our healthcare system in the late 20th century, the way we discuss health has centered around weight and body size, despite research that has shown Social Determinants of Health (SDOH) are fundamental for improving health and reducing longstanding inequities.
This is what is called a weight normative or weight centric approach to healthcare. In this approach, weight becomes the main determinant of health, which rests on the assumption that “weight and disease are related in a linear fashion, with disease and weight increasing in tandem.” While there is certainly a correlation between the two, it should not sit at the center of how we receive care.
In comparison, a weight inclusive approach “rests on the assumption that everybody is capable of achieving health and well-being independent of weight, given access to nonstigmatizing health care.”
This approach is more inclusive since it does not rely on BMI as an accurate measure of health and minimizes weight bias from providers and researchers.
Weight Inclusivity in Practice
So what does this look like in practice? The Association for Size Diversity and Health (ASDAH) lists the Health at Every Size® Principles as follows:
Healthcare is a human right for people of all sizes, including those at the highest end of the size spectrum.
Wellbeing, care, and healing are resources that are both collective and deeply personal.
Care is fully provided only when free from anti-fat bias and offered with people of all sizes in mind.
Health is a sociopolitical construct that reflects the values of society.
They have also developed the Health at Every Size® Framework of Care to “serve as a roadmap for Healthcare Providers to become Health at Every Size®-aligned.” Those core elements are:
Grounding in liberatory frameworks
Patient bodily autonomy
Informed consent
Compassionate care
Skills and equipment to provide compassionate and comprehensive care for fat people’s bodies
Critical analysis, application, and execution of research & medical recommendations related to weight
Provider roles and responsibilities
Tools that support wellbeing and healing without contributing to oppression
Addressing your anti-fat bias
Addressing systemic anti-fat bias
Ultimately, it should be our goal to provide access and education so folks can create healthy lifestyle habits that are sustainable for their individual life.
