8 Tips for Addressing Weight-related Issues While Promoting Health and Well-being
1. Be aware of weight stigma
Weight bias and stigma are social justice issues, impacting millions of patients on a daily basis and leading to health inequities. It’s important for us to be receptive to addressing our internalized weight biases and to consider that some interventions, including prescribing dieting and focusing on weight versus health, can cause harm.
2. Have compassion and seek to understand
Given that weight can be a highly personal and sensitive issue, to avoid possible psychological harm and arrive at effective solutions, approach conversations and actions to address weight-related issues compassionately and with understanding, not judgment.
3. Develop awareness of the needs of all of your patients
Create a setting where all your patients feel respected and safe. This may include thinking about furniture in the office, blood pressure cuffs, etc. Train staff on procedures around weight and appropriate methods for weighing patients. Consider the possibility that weighing the patient may or may not be of service for them.
4. Recognize that weight gain is not always caused by eating an excess of food
Genetics and medical conditions known to cause weight gain play a greater role in a person’s weight than their behavior does. In addition, the weight cycling resulting from dieting comes with many risks, including inflammation, decreased metabolism, and decreased self esteem.
5. Do not assume that because someone is of a larger size, they are either unhealthy or overeating
Size variability is normal. A person’s size is only part of the picture and does not necessarily reflect their diet or activity levels. All of this needs to be explored in a respectful, professional manner.
6. Focus on enhancing mental and physical health and well-being, not on weight
Weight is only one small part of health and well-being. Rather than focus on the scale, it is better to focus on adopting behaviors that lead to mental and physical well-being, such as healthful eating, enjoyable physical activity, satisfaction with one’s self and body – no matter what weight or size.
7. Find effective language to address the medical problems the patient may be experiencing
Understanding weight stigma may help create a language that will allow building healthy and helpful partnerships with our patients. This will result in our patients feeling safe, understood, and above all, not shamed through their interactions with the medical team.
8. Address the broad determinants of mental and physical well-being
Many factors that impact health and well-being are beyond the control of individual. Addressing these determinants of health can reduce rates of chronic disease and afford people an equal opportunity to flourish in life.
About Health at Every Size® [HAES®]
HAES supports people in adopting lifestyle habits for the sake of health and/or well-being (rather than weight control). The HAES trademark is owned by the Association of Size Diversity and Health (ASDAH).
The HAES Principles help to advance social justice, creating an inclusive and respectful community and supporting people of all sizes in finding compassionate ways to take care of themselves:
Weight Inclusivity: Accept and respect the inherent diversity of body shapes and sizes and reject the idealizing or pathologizing of specific weights.
Health Enhancement: Support health policies that improve and equalize access to information and services, and personal practices that improve human well-being, including attention to individual physical, economic, social, spiritual, emotional, and other needs.
Respectful Care: Acknowledge our biases, and work to end weight discrimination, weight stigma, and weight bias.
Eating for Well-being: Promote flexible, individualized eating based on hunger, satiety, nutritional needs, and pleasure, rather than any externally regulated eating plan focused on weight control.
Life-Enhancing Movement: Support physical activities that allow people of all sizes, abilities, and interests to engage in enjoyable movement, to the degree that they choose.
What HAES is NOT:
HAES does not assume that everyone is healthy at the size they are now, but that health can be achieved at any size
HAES does not recommend eating whatever and whenever you want, without regard for the impact it will have on body and mind
HAES is not against weight loss; it is against making weight loss the focus of treatment
Adapted from:
BEDA, the HAES Curriculum and from my own Intuitive Eating Workshop materials
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