Written by Erin Walden
Edited by Jinshi Zheng
But more than affecting financial stability, widespread weight discrimination affects mental and physical health. One of the many problems with weight stigma is that individuals tend to internalize anti-fat beliefs, making them less likely to advocate for themselves and to be comfortable accessing healthcare. Hospitals and doctor’s offices are places where the body is put on full display and where body size is an indicator of health.
There are many factors that influence weight, and to generate a conclusive healthy/unhealthy diagnosis using the appearance of weight is deceptive. In fact, weight has been shown to be a less important measurement than blood pressure, resting heart rate, heart rate recovery, and cholesterol . The problem is that these are not visible factors. Bianca Santaromita-Villa, a Dietitian from Ontario notes that, “someone in a larger body could be consuming the exact same thing as someone in a smaller body, doing the same exercises, and they are still going to live in that larger body.” Many people believe that encouraging weight loss is beneficial, but in reality, “[fat] stigma is not a beneficial public health tool for reducing obesity or improving health. Rather, stigmatization of obese individuals pose serious risks to their psychological and physical health, generates health disparities, and interferes with implementation of effective obesity prevention efforts.” 
Some studies have looked at the impact of weight stigma in healthcare. Researchers found that fat cis women are less likely to receive cervical cancer, breast cancer, and colorectal cancer screenings than non-fat cis women are. Fat women with breast and cervical cancers are more likely to die from these cancers than non-fat women with the same conditions. In this study, “fat” refers to those with a BMI over 30 (obese on the BMI chart). In another study, 68% of almost 500 fat women reported a delay in seeking care because of their weight and 85% reported weight was a barrier to receiving appropriate healthcare.
Though there have been efforts to change how fat people are treated in healthcare, many barriers exist to bettering the system. One woman, Cat Pausé, discussed how difficult it was to start her medical residency because of her weight. After three rounds of completing immigration checks, she was deemed to not meet the acceptable standard of health based on her BMI.
It was so incredibly frustrating; to undergo additional testing because they couldn't believe that someone so fat was metabolically healthy. A few weeks later, I received the decision from Immigration that I was denied residency because I did not meet the medical standard required. Based solely on my BMI. All of my medical tests had been good. Nothing raised any flags, or fell outside of normal parameters. But my BMI was over 30, so nothing else apparently mattered. And the belief that because of my BMI, I would end up costing up to $25,000 in medical care costs during my time in New Zealand.
Fat people that understand what it is like to live in their bodies and are well-equipped to provide for others that have similar experiences are being prevented from becoming doctors due to the outdated BMI system.
The focus on BMI as a be-all and end-all of health is called the “Weight Normative Approach.”  The Weight Inclusive Approach, however, challenges the belief that a particular BMI reflects health status and suggests that wellness can be fostered independent of weight. It is an approach that celebrates the natural diversity of bodies and seeks to eradicate stigmatization within healthcare.In line with the Weight Inclusive Approach, many doctors and hospitals are starting to adopt the Health at Every Size (HAES) guidelines. These guidelines, developed by Dr. Linda Bacon, outline that weight inclusivity, health enhancement, respectful care, eating for well-being, and life-enhancing movement can be the foundations for creating change in communities, including the healthcare community. The Association for Size Diversity and Health (ASDAH) is a professional organization that supports the HAES principles; it aims to promote health, well-being and respect for all bodies.
Doctors are moving away from using weight, BMI, and calorie intake as determinants of health. These numerical measurements may be quick and easy to take, but do not offer a personalized or inclusive model of healthcare. If the healthcare community wants to change, they must work to decenter the element of weight from the concept of health. Changing conceptions of health starts with educating ourselves on the negative impacts of our current system and working within our communities to create and uplift a system that works for all people.
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